Indagine sulla presenza di Helicobacter pullorum in allevamenti avicoli italiani

From September 2005 to December 2006, in order to define the prevalence of Helicobacter pullorum in broiler chickens, laying hens and turkey, a total of 365 caecum contents of animals reared in 76 different farms were collected at the slaughterhouse. A caecum content of a ostrich was also sampled. In addition, with the aim of investigating the occurrence of H. pullorum in humans, 151 faeces were collected at the Sant’Orsola-Malpighi University Hospital of Bologna from patients suffering of gastroenteritis. A modified Steele–McDermott membrane filter method was used. Gram-negative curved rod bacteria were preliminary identified as H. pullorum by a PCR assay based on 16S rRNA, then subjected to a RFLP-PCR assay to distinguish between H. pullorum and H. canadensis. One isolate from each farm was randomly selected for phenotypic characterization by biochemical methods and 1D SDSPAGE analysis of whole cell proteins profiles. Minimum Inhibitory Concentration (MIC) for seven different antibiotics were also determined by agar dilution method. Moreover, to examine the intraspecific genomic variability, two strains isolated from 17 different farms were submitted to genotyping by Pulse-Field Gel Electrophoresis (PFGE). In order to assess the molecular basis of fluorquinolone resistance in H. pullorum, gyrA of H. pullorum CIP 104787T was sequenced and nucleotide sequences of the Quinolone Resistance Determining Region (QRDR) of a total of 18 poultry isolates, with different MIC values for ciprofloxacin and nalidixic acid, were compared. According to the PCR and PCR-RFLP results, 306 out of 366 animals examined were positive for H. pullorum (83,6%) and 96,1% of farms resulted infected. All positive samples showed a high number of colonies (>50) phenotipically consistent with H. pullorum on the first isolation media, which suggests that this microrganism, when present, colonizes the poultry caecum at an elevate load. No human sample resulted positive for H. pullorum. The 1D SDS-PAGE whole protein profile analysis showed high similarity among the 74 isolates tested and with the type strain H. pullorum CIP 104787T. Regarding the MIC values, a monomodal distribution was found for ampicillin, chloramphenicol, gentamicin and nalidixic acid, whereas a bimodal trend was noticed for erythromycin, ciprofloxacin and tetracycline (indicating an acquired resistance for these antibiotics). Applying the breakpoints indicated by the CSLI, we may assume that all the H. pullorum tested are sensitive only to gentamicin. The intraspecific genomic variability observed in this study confirm that this species don’t have a clonal population structure, as motioned by other autors. The 2490 bp gyrA gene of H. pullorum CIP104787T with an Open Reading Frame (ORF) encoding a polypeptide of 829 amino acids was for the first time sequenced and characterized. All ciprofloxacin resistant poultry isolates showed ACA®ATA (Thr®Ile) substitution at codon 84 of gyrA corresponding to codons of gyrA 86, 87 and 83 of the Campylobacter jejuni, H. pylori and Escherichia coli, respectively. This substitution was functionally confirmed to be associated with the ciprofloxacin resistant phenotype of poultry isolates. This is the first report of isolation of H. pullorum in turkey and in ostrich, indicating that poultry species are the reservoir of this potential zoonotic microorganisms. In order to understand the potential role as food-borne human pathogen of H. pullorum, further studies must be carried on.

Toward a 3D in vitro model based on decellularized thymus to maintain adult thymic ephitelial cells functionality

During my PhD,I have been develop an innovative technique to reproduce in vitro the 3D thymic microenvironment, to be used for growth and differentiation of thymocytes, and possible transplantation replacement in conditions of depressed thymic immune regulation. The work has been developed in the laboratory of Tissue Engineering at the University Hospital in Basel, Switzerland, under the tutorship of Prof.Ivan Martin. Since a number of studies have suggested that the 3D structure of the thymic microenvironment might play a key role in regulating the survival and functional competence of thymocytes, I’ve focused my effort on the isolation and purification of the extracellular matrix of the mouse thymus. Specifically, based on the assumption that TEC can favour the differentiation of pre-T lymphocytes, I’ve developed a specific decellularization protocol to obtain the intact, DNA-free extracellular matrix of the adult mouse thymus. Two different protocols satisfied the main characteristics of a decellularized matrix, according to qualitative and quantitative assays. In particular, the quantity of DNA was less than 10% in absolute value, no positive staining for cells was found and the 3D structure and composition of the ECM were maintained. In addition, I was able to prove that the decellularized matrixes were not cytotoxic for the cells themselves, and were able to increase expression of MHC II antigens compared to control cells grown in standard conditions. I was able to prove that TECs grow and proliferate up to ten days on top the decellularized matrix. After a complete characterization of the culture system, these innovative natural scaffolds could be used to improve the standard culture conditions of TEC, to study in vitro the action of different factors on their differentiation genes, and to test the ability of TECs to induce in vitro maturation of seeded T lymphocytes.

Effetto dell'analgesia epidurale sulla progressione della testa fetale valutata mediante ecografia 3D

Introduzione: L'analgesia epidurale è stata messa in correlazione con l'aumento della durata del secondo stadio del travaglio e del tasso di utilizzo della ventosa ostetrica. Diversi meccanismi sono stati ipotizzati, tra cui la riduzione di percezione della discesa fetale, della forza di spinta e dei riflessi che promuovono la progressione e rotazione della testa fetale nel canale del parto. Tali parametri sono solitamente valutati mediante esame clinico digitale, costantemente riportato essere poco accurato e riproducibile. Su queste basi l'uso dell'ecografia in travaglio, con introduzione di diversi parametri ecografici di valutazione della discesa della testa fetale, sono stati proposti per supportare la diagnosi clinica nel secondo stadio del travaglio. Scopi dello studio: studiare effetto dell’analgesia epidurale sulla progressione della testa fetale durante il II stadio del travaglio valutata mediante ecografia intrapartum. Materiali e metodi: una serie di pazienti nullipare a basso rischio a termine (37+0-42+0) sono state reclutate in modo prospettico nella sala parto del nostro Policlinico Universitario. In ciascuna di esse abbiamo acquisito un volume ecografico ogni 20 minuti dall’inizio della fase attiva del secondo stadio fino al parto ed una serie di parametri ecografici sono stati ricavati in un secondo tempo (angolo di progressione, distanza di progressione distanza testa sinfisi pubica e midline angle). Tutti questi parametri sono stati confrontati ad ogni intervallo di tempo nei due gruppi. Risultati: 71 pazienti totali, di cui 41 (57.7%) con analgesia epidurale. In 58 (81.7%) casi il parto è stato spontaneo, mentre in 8 (11.3%) e 5 (7.0%) casi rispettivamente si è ricorsi a ventosa ostetrica o taglio cesareo. I valori di tutti i parametri ecografici misurati sono risultati sovrapponibili nei due gruppi in tutti gli intervalli di misurazione. Conclusioni: la progressione della testa fetale valutata longitudinalmente mediante ecografia 3D non sembra differire significativamente nelle pazienti con o senza analgesia epidurale.

Confronto fra cerchiaggio cervicale elettivo, eco-indicato e d’emergenza dal 2001 al 2013

Obiettivi: L’obiettivo dello studio è stato quello di valutare l’utilizzo del cerchiaggio cervicale, in relazione alle diverse indicazioni per cui è stato eseguito, presso la Clinica Ostetrica e Ginecologica del Policlinico Universitario Sant’Orsola-Malpighi di Bologna, tra Gennaio 2001 e Dicembre 2013. Outcome secondario e’ stato quello di paragonare i risultati ottenuti con le più recenti evidenze scientifiche per valutare come esse abbiano influenzato l’utilizzo del cerchiaggio nel nostro centro. Materiali e metodi: valutazione osservazionale di tutte le pazienti sottoposte a cerchiaggio cervicale presso il nostro centro. La popolazione di studio e’ stata suddivisa in 5 gruppi in relazione all’indicazione per cui il cerchiaggio e’ stato eseguito: cerchiaggio elettivo (I), eco indicato (II), d’emergenza (III), in gravidanze gemellari (IV) e in gravidanze trigemine (V). Di tutte le pazienti e’ stato valutato l’outcome della gravidanza (epoca gestazionale al parto, peso neonatale, Apgar score) e l’appropriatezza dell’indicazione al cerchiaggio. Risultati: nel corso dei 13 anni in studio sono stati eseguiti 191 cerchiaggi: 109 nel I gruppo, 24 nel II, 39 nel III, 13 e 6 rispettivamente nel IV e V gruppo. In un caso il cerchiaggio e’ stato eseguito per via laparoscopica prima dell’insorgenza della gravidanza. La distribuzione dei diversi tipi di cerchiaggio e’ cambiata: dal 2007 non vengono seguiti cerchiaggi in gravidanze multiple, sono diminuiti quelli elettivi e sono aumentati i cerchiaggi d’emergenza pur essendo i casi con morbilità materna maggiore: in una paziente si e’ verificato un aborto settico con shock settico materno e si e’ reso necessario un intervento di isterectomia. Conclusioni: l'applicazioni di indicazioni piu' selettive all’esecuzione del cerchiaggio hanno determinato una forte riduzione dell’utilizzo da tale procedura. L'aumento dell'utilizzo del cerchiaggio d’emergenza e' legato al fatto che rappresenta l’ultima chance per convertire un aborto inevitabile in un parto di neonato vivo in casi estremi.

Advanced aspects of radiation protection in the use of particle accelerators in the medical field

In this work, the well-known MC code FLUKA was used to simulate the GE PETrace cyclotron (16.5 MeV) installed at “S. Orsola-Malpighi” University Hospital (Bologna, IT) and routinely used in the production of positron emitting radionuclides. Simulations yielded estimates of various quantities of interest, including: the effective dose distribution around the equipment; the effective number of neutron produced per incident proton and their spectral distribution; the activation of the structure of the cyclotron and the vault walls; the activation of the ambient air, in particular the production of 41Ar, the assessment of the saturation yield of radionuclides used in nuclear medicine. The simulations were validated against experimental measurements in terms of physical and transport parameters to be used at the energy range of interest in the medical field. The validated model was also extensively used in several practical applications uncluding the direct cyclotron production of non-standard radionuclides such as 99mTc, the production of medical radionuclides at TRIUMF (Vancouver, CA) TR13 cyclotron (13 MeV), the complete design of the new PET facility of “Sacro Cuore – Don Calabria” Hospital (Negrar, IT), including the ACSI TR19 (19 MeV) cyclotron, the dose field around the energy selection system (degrader) of a proton therapy cyclotron, the design of plug-doors for a new cyclotron facility, in which a 70 MeV cyclotron will be installed, and the partial decommissioning of a PET facility, including the replacement of a Scanditronix MC17 cyclotron with a new TR19 cyclotron.

Adulthood with Turner Syndrome: Quality of life, psychosocial adjustment and clinical management in 70 Italian women

Abstract Background: Turner syndrome (TS) is a chromosomal abnormality (total or partial absence of one of the sexual chromosomes in some or all cells of the body), which affects approximately 1:2000 female. Principal characteristics are short stature and gonadal disgenesis. Clinical management consist of Growth Hormone (GH) treatment and oestrogen replacement therapy (HRT), to induce development of secondary characteristics and to avoid the sequelae of oestrogen deficiency. Aim of the study: To assess clinical management, quality of life (QoL) and general psychosocial adjustment of women with TS. Population: 70 adult Caucasian females with TS (mean age: 27.8, ± 7.6; range 18-48 y.). Setting: Specialist service for Rare Disease care, University Hospital. Methods: Subjects were required to fill in questionnaires collecting ASR, WHOQOL, and 8 open questions. Data were compared with those of the Italian population or to those collected in a comparison group (70 healthy females, mean age: 27.9, ±7.3, range 21-48 y.). Results: Women with TS are educated as well as the Italian Population, but they have a less successful professional life. They show good QoL in general, but they appeared less satisfied in social area. They had statistically higher scores than the comparison group for depression, anxiety and withdrawal. Are less involved in a love relationship. Diagnosis communication was mostly performed by doctors or parents, satisfaction was higher when information was given by parents. Main preoccupation about TS are infertility, feeling of being different and future health problem. Conclusions: Italian people with TS were generally well adapted and have a good QoL, but lived more often with parents and show impaired sentimental and sexual life. They have higher degree of psychological distress compared to a comparison group. Psychological intervention should firstly address parents in order to encourage an open communication on diagnosis issues and on sexual education.