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Ateka-Barrutia O, Palma Dos Reis I, Maina A, Bezanahary H. Obstetric medicine care in South Europe. Obstet Med 2021; 14:145-152. [PMID: 34646342 DOI: 10.1177/1753495x20945569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/07/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022] Open
Abstract
Obstetric medicine is an emerging area of interest within Internal Medicine in Europe. Despite that, "OM" is still an unpopular concept and an unrecognised subspecialty in South Europe. A considerable number of internists and medical specialists deal with maternal medical problems in association with obstetricians and other specialists on a daily basis. Due to their interest and mostly part-time dedication to maternal care, a growing mass of physicians are getting specific training in the field either locally or, less frequently, abroad, and are also building specific clinics, inpatient care services and other new bonds with obstetricians in numerous tertiary care centres. In this article, we aim to describe the state of the growing field of obstetric medicine in Portugal, Italy, France and Spain, the particular clinical, educational and academic efforts and steps that have recently been developed by internists in each country, as well as planned initiatives for the future.
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Affiliation(s)
| | - I Palma Dos Reis
- Internal Medicine, Hospital Professor Doutor Fernando Fonseca, Lisbon, Portugal
| | - A Maina
- Internal Medicine, Ospedale Sant'Anna, Città della Salute e della Scienza, Torino, Italy
| | - H Bezanahary
- Internal Medicine, Limoges University Hospital, Limoges, France
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Ge H, Farris CM, Tong M, Maina A, Richards AL. Transcriptional profiles of cytokines and chemokines reveal important pro-inflammatory response from endothelial cells during Orientia tsutsugamushi infection. Microbes Infect 2019; 21:313-320. [PMID: 30684683 DOI: 10.1016/j.micinf.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 01/14/2019] [Indexed: 01/18/2023]
Abstract
Endothelial cells (EC) are key targets during Orientia tsutsugamushi infection. Knowledge of the pro-inflammatory response against O. tsutsugamushi by ECs is limited. The aim of the present study was to characterize the pro-inflammatory transcriptional response during the first 24 h of infection of the human dermal microvascular endothelial cell line with O. tsutsugamushi Karp by examining five-time points. The transcriptional profiles of 84 genes including cytokines, chemokines, growth factors, and TNF receptor superfamily genes were studied using a RT-PCR array. We identified 40 of the 84 genes that were up or down modulated during the early O. tsutsugamushi infection that differed remarkably from genes of non-infected cells. The modulated genes included: the interleukins (IL-1α/β, IL-4, IL-6, IL-7, IL-10, IL-11, IL-18, and IL-24), chemokines (CXCL8, CCL2/MCP1, CCL5/RANTES, and CCL17), growth factors (NODAL, CNTF, and CSF2/GM-CSF), and TNFSF13B. IL-1β, IL-4, and IL-11 were highly induced at one hour post infection, whereas, CCL17 was profoundly up-regulated and IFNα2 was greatly down-regulated during the entire 24-hour time course. These results provide insight into the early pro-inflammatory response of endothelial cells to O. tsutsugamushi infection and indicate their potential role in the pathophysiology of the host's initial response to O. tsutsugamushi infection.
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Affiliation(s)
- Hong Ge
- Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, USA
| | - Christina M Farris
- Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, USA; US Naval Medical Research Unit No. 2, Phnom Penh, Cambodia
| | - Min Tong
- Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, USA
| | - Alice Maina
- Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, USA
| | - Allen L Richards
- Viral and Rickettsial Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, USA.
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Horton KC, Jiang J, Maina A, Dueger E, Zayed A, Ahmed AA, Pimentel G, Richards AL. Evidence of Rickettsia and Orientia Infections Among Abattoir Workers in Djibouti. Am J Trop Med Hyg 2016; 95:462-5. [PMID: 27273647 DOI: 10.4269/ajtmh.15-0775] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 04/15/2016] [Indexed: 11/07/2022] Open
Abstract
Of 49 workers at a Djiboutian abattoir, eight (16%, 95% confidence interval [CI]: 9-29) were seropositive against spotted fever group rickettsiae (SFGR), two (4%, 95% CI: 1-14) against typhus group rickettsiae, and three (6%, 95% CI: 2-17) against orientiae. One worker (9%, 95% CI: 2-38) seroconverted against orientiae during the study period. This is the first evidence of orientiae exposure in the Horn of Africa. SFGR were also identified by polymerase chain reaction in 32 of 189 (11%, 95% CI: 8-15) tick pools from 26 of 72 (36%) cattle. Twenty-five (8%, 95% CI: 6-12) tick pools were positive for Rickettsia africae, the causative agent of African tick-bite fever. Health-care providers in Djibouti should be aware of the possibility of rickettsiae infections among patients, although further research is needed to determine the impact of these infections in the country.
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Affiliation(s)
- Katherine C Horton
- Global Disease Detection Regional Center, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt.
| | - Ju Jiang
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland
| | - Alice Maina
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland
| | - Erica Dueger
- Global Disease Detection Regional Center, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt. Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alia Zayed
- Vector Biology Research Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - Ammar Abdo Ahmed
- Department of Epidemiology and Health Information, Ministry of Health, Djibouti, Djibouti
| | - Guillermo Pimentel
- Biological Defense Research Directorate, Naval Medical Research Center, Silver Spring, Maryland
| | - Allen L Richards
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland
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Krueger L, Bai Y, Bennett S, Fogarty C, Sun S, Kosoy M, Maina A, Nelson K, Platzer E, Osikowicz L, Richards AL, Shariar F, Trinidad A, Cummings A, Cummings R. Identification of Zoonotic and Vector-borne Infectious Agents Associated with Opossums (Didelphis virginiana) in Residential Neighborhoods of Orange County, California. ACTA ACUST UNITED AC 2016. [DOI: 10.5070/v427110386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Maina A, Arrotta M, Cicogna L, Donvito V, Mischinelli M, Todros T, Rivolo S. Transdermal clonidine in the treatment of severe hyperemesis. A pilot randomised control trial: CLONEMESI. BJOG 2014; 121:1556-62. [DOI: 10.1111/1471-0528.12757] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2013] [Indexed: 12/27/2022]
Affiliation(s)
- A Maina
- Dipartimento di Medicina; Servizio di Medicina Interna; Ospedale Sant'Anna; AOU Città della Salute e della Scienza; Turin Italy
| | - M Arrotta
- Dipartimento di Medicina; Servizio di Medicina Interna; Ospedale Sant'Anna; AOU Città della Salute e della Scienza; Turin Italy
| | - L Cicogna
- Dipartimento di Medicina; Servizio di Medicina Interna; Ospedale Sant'Anna; AOU Città della Salute e della Scienza; Turin Italy
| | - V Donvito
- Dipartimento di Medicina; Servizio di Medicina Interna; Ospedale Sant'Anna; AOU Città della Salute e della Scienza; Turin Italy
| | - M Mischinelli
- Divisione di Medicina Materno-Fetale; Dipartimento di Ostetricia e Ginecologia; Università di Torino; Turin Italy
| | - T Todros
- Divisione di Medicina Materno-Fetale; Dipartimento di Ostetricia e Ginecologia; Università di Torino; Turin Italy
| | - S Rivolo
- Division of Imaging Sciences and Biomedical Engineering; Department of Biomedical Engineering; King's College London; St. Thomas' Hospital; London UK
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Balbi L, Donvito V, Maina A. Obstetric medicine. Ital J Med 2013. [DOI: 10.4081/itjm.2007.1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Obstetric assistance made major advances in the last 20 years: improved surgical technique allows quicker caesarean sections, anaesthesiology procedures such as peripheral anaesthesia and epidural analgesia made safer operative assistance, remarkably reducing perioperative morbidity and mortality, neonatology greatly improved the results of assistance to low birth weight newborns. A new branch of medicine called “obstetric medicine” gained interest and experience after the lessons of distinguished physicians like Michael De Swiet in England. All together these advances are making successful pregnancies that 20 years ago would have been discouraged or even interrupted: that’s what we call high risk pregnancy. High risk of what? Either complications of pregnancy on pre-existing disease or complications of pre-existing disease on pregnancy. Nowadays, mortality in pregnancy has a medical cause in 80% of cases in Western countries (Confidential Enquiry on Maternal Deaths, UK, 2004). DISCUSSION The background is always changing and we have to take in account of: increase of maternal age; widespread use of assisted fertilization techniques for treatment of infertility; social feelings about maternity desire with increasing expectations from medical assistance; immigration of medically “naive” patients who don’t know to have a chronic disease, but apt and ready to conceive; limited knowledge of feasibility of drug use in pregnancy which may induce both patients and doctors to stopping appropriate drug therapy in condition of severe disease. Preconception counseling, planning the pregnancy, wise use of drugs, regular follow-up throughout the pregnancy and, in selected cases, preterm elective termination of pregnancy may result in excellent outcome both for mother and foetus. CONCLUSIONS Highly committed and specifically trained physicians are required to counsel these patients and to plan their treatment before and during pregnancy.
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Ciccorossi P, Colombatto P, Maina A, Civitano L, Oliveri F, Sacco R, Coco B, Bonino F, Brunetto M. O.091 Early prediction of response to Peg-IFNα-2a or Peg-IFNα-2b plus ribavirin in the single chronic hepatitis C patients by modeling the dynamics of infected cells. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80088-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Flichman D, Maina A, Colombatto P, Bonino F, Brunetto MR. Validation and comparison of different PCR-based methods for detection of hepatitis B virus precore region mutants. J Virol Methods 2005; 129:64-74. [PMID: 15993954 DOI: 10.1016/j.jviromet.2005.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2005] [Revised: 05/03/2005] [Accepted: 05/04/2005] [Indexed: 11/19/2022]
Abstract
Hepatitis virus variants detection is useful in clinical practice; however, methods that are used for their identification may influence the results significantly. Three PCR-based assays for quantitation of G1896A precore HBV mutants: two allele specific PCRs, single tube (single-AS-PCR) with enzymatic restriction or separate tubes (twin-AS-PCR) and one oligohybridization assay (OA) with three probes were developed and standardized. Wild type and mutant plasmids and 10 sera were used as reference. All methods had sensitivity limits of 10(4)copies/ml and their specificity encompassed 3 logs (10(4)-10(7)copies/ml) with dynamic ranges of logs for OA, twin-AS-PCR and single-AS-PCR, respectively. Single-AS-PCR and OA detected minor viral populations when their relative prevalence was at least 10% of the overall viral population whereas their detection by twin-AS-PCR ranged from 0.1 to 10% for samples with 10(7) and 10(5)copies/ml viral loads, respectively. Twin-AS-PCR was the most sensitive to detect the minor viral population, whereas single-AS-PCR and OA were more accurate to quantify the relative proportions of the two viral populations independently of the overall viral load. In conclusion, an accurate characterization of HBV precore heterogeneity should be warranted by a careful choice of the most appropriate assay according to the aim of the study.
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Affiliation(s)
- D Flichman
- UO Gastroenterologia ed Epatologia, Azienda Ospedaliero Universitaria Pisana, Via Paradisa 2, 56124 Pisa, Italy
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Colombatto P, Brunetto MR, Kansopon J, Oliveri F, Maina A, Aragon U, Bortoli ML, Scatena F, Baicchi U, Houghton M, Bonino F, Weiner AJ. High prevalence of G1 and G2 TT-virus infection in subjects with high and low blood exposure risk: identification of G4 isolates in Italy. J Hepatol 1999; 31:990-6. [PMID: 10604571 DOI: 10.1016/s0168-8278(99)80310-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS A non-enveloped single-stranded DNA virus (TTV) was detected in Japanese patients with fulminant hepatitis (47%) and chronic liver disease of unknown etiology (46%) more frequently than in blood donors (12%). Subsequent studies, however, questioned the association of TTV with liver disease. We further investigated the role of this novel virus in liver diseases. METHODS We tested 106 patients and 102 blood donors for TTV by polymerase chain reaction using conserved region primers. RESULTS TTV DNA was found in 19 of 102 volunteer blood donors (18.6%) and in 27 of 106 patients with liver disease (25.5%): 10 of 28 chronic hepatitis B (35.7%), 9 of 28 chronic hepatitis C (32.1%) and 8 of 50 (16%) cryptogenic liver disease patients. Previous interferon treatment was not associated with a significantly lower prevalence of TTV infection. TTV prevalence was higher in patients with blood exposure (42.8%, 6/14) than in patients without risk factors (21.4%, 18/84). Four of five patients (80%) with HBV familial infection and without blood exposure were also TTV positive. Partial nucleotide sequences from 3 Italian isolates diverged more than 30% from the 2 prototype genotypes G1 and G2 and were 88% homologous to the recently described genotype G4. CONCLUSIONS G1 and G2 TTV are common in Italy and in the USA in liver disease patients and in blood donors. The prevalence is high in patients with blood exposure but also in subjects without risk factors; other routes of transmission should therefore be considered.
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Affiliation(s)
- P Colombatto
- Gastroenterology and Hepatology Unit, Spedali Riuniti Santa Chiara, Azienda Ospedaliera Pisana, Cisanello, Pisa, Italy
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Abstract
We considered the association between diabetes and risk of endometrial cancer using data from a large case-control study conducted in Italy. Cases were 752 women with incident, histologically confirmed endometrial cancer < 75 years of age (median age 60 years, range 28-74) admitted to a network of hospitals in Milan. Controls were 2,606 patients (median age 54 years, range 25-74) aged < 75 years, admitted for acute non-neoplastic, non-gynecological, non-hormone-related conditions to the same network of hospitals where cases had been identified. A total of 132 (17.6%) cases and 116 controls (4.5%) reported a history of diabetes. The corresponding multivariate odds ratio (OR) was 2.9 [95% confidence interval (CI) 2.2-3.9]. No association emerged with diabetes diagnosed under age 40 (likely to be insulin-dependent diabetes), whereas the OR of endometrial cancer was 3.1 (95% CI 2.3-4.2) for diabetes diagnosed at age > or = 40 years. The OR of endometrial cancer in women with history of diabetes was 3.0 for women with a body mass index (BMI) (QI) kg/m2 < 25, 3.6 for those with a BMI of 25-29, and 3.3 for those with a BMI > or = 30. No consistent interaction or modifying effect was observed for any other covariate. Our results confirm that non-insulin-dependent diabetes is associated with the risk of endometrial cancer. The association may be mediated through elevated oestrogen levels in diabetic women, hyperinsulinemia or insulin-like growth factor-I (IGF-I).
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Affiliation(s)
- F Parazzini
- Istituto di Ricerche Farmacologiche Mario Negri, and I Clinica Ostetrico Ginecologica, Università di Milano, Milan, Italy.
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Stratta P, Canavese C, Porcu M, Dogliani M, Todros T, Garbo E, Belliardo F, Maina A, Marozio L, Zonca M. Vitamin E supplementation in preeclampsia. Gynecol Obstet Invest 1994; 37:246-9. [PMID: 8050728 DOI: 10.1159/000292570] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
An oxidant/antioxidant imbalance has been suggested among the pathogenetic factors involved in preeclampsia. As vitamin E is one of the most important antioxidant body components, a nonrandomized controlled trial was undertaken in 36 preeclamptic patients in order to evaluate the effect of vitamin E supplementation (100-300 mg/day per os) on fetal and maternal outcome. Fetal mortality was similar in 14 patients treated with conventional therapy plus oral vitamin E supplementation (35%) and in 22 patients treated with conventional therapy only (36%). Furthermore, in both groups of patients proteinuria increased, and increased dosages of antihypertensive drugs were called for in order to control blood pressure. We conclude that, with these dosages and in case of an already established disease, vitamin E does not improve fetal outcome in severe preeclampsia. Furthermore, it does not show favorable effects on maternal hypertension and proteinuria.
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Affiliation(s)
- P Stratta
- Department of Nephrology, University of Torino, Italy
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Maina A, Donvito V, Giachino O, Stratta P, Camaschella C. Thrombotic thrombocytopenic purpura in pregnancy with maternal and fetal survival. Case report. Br J Obstet Gynaecol 1990; 97:443-5. [PMID: 2372528 DOI: 10.1111/j.1471-0528.1990.tb01833.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- A Maina
- Servizio di Medicina Interna, Ospedale S. Anna, Torino, Italy
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Arisio R, Carbone G, Maina A, Donvito V. Pneumothorax as a complication of fine needle aspiration of the breast. Panminerva Med 1988; 30:58-9. [PMID: 3419857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Rolla G, Bucca C, Polizzi S, Giachino O, Maina A, Arossa W, Spinaci S. Site of airway obstruction after rapid saline infusion in healthy subjects. Respiration 1983; 44:90-6. [PMID: 6836194 DOI: 10.1159/000194533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Static and dynamic lung volumes, flow-volume curve in air and after He-O2 were carried out in 5 normal subjects baseline, immediately after rapid infusion of 2 litres of normal saline, and then 15, 30 and 60 min after. At the end of the infusion, a marked reduction of delta MEF50, FVC, FEV1, MEF50, MEF25 and an increase of Viso V and CV/VC were observed in all the subjects. The poor response to He-O2 suggests a predominant increase of small airway resistance after rapid infusion. In the recovery phase, He-O2 tests promptly returned to control values, while an increased CV/VC was detectable until 30 min after the infusion.
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