1
|
Giorgi PD, Legrenzi S, Sacchi L, Boeris D, Villa FG, Bove F, Puglia F, Schirò GR. Implementation of Robotic Exoscope in Minimally Invasive Corpectomy at Thoracolumbar Junction for the Treatment of Traumatic Spinal Cord Compression. World Neurosurg 2024; 184:23-28. [PMID: 38184228 DOI: 10.1016/j.wneu.2023.12.163] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/08/2024]
Abstract
The development and diffusion of minimally invasive (MI) approaches have coincided with improvements in magnification systems. The exoscope will probably open a new era in new technologies in spinal surgery. This study reports a retrospective series of 19 thoracolumbar (T11-L2) burst fractures with anterior column failure and cord compression, treated with MI corpectomy and spinal decompression assisted by a three-dimensional high-definition exoscope (Video 1). Exclusion criteria were pathologic or osteoporotic fractures, multilevel fractures, and previous surgery at the site of the fracture. Three key indicators were recorded: surgical time, blood loss, and intraoperative complications. A questionnaire was administered to assess the users' exoscope experience with ergonomics, preparation, magnification, image definition, illumination, and user-friendliness, compared with the operative microscope. To the best of our knowledge, this is the first study reporting on exoscope-assisted MI corpectomy. This procedure permitted low blood loss and less surgical time without intraoperative complications. The exoscope offers clear advantages in terms of ergonomics, definition, and user-friendliness. Moreover, it is a suitable instrument for training and education, providing an opportunity for better interaction with other members of the surgical staff.
Collapse
Affiliation(s)
- Pietro Domenico Giorgi
- Orthopedics and Traumatology Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Simona Legrenzi
- Orthopedics and Traumatology Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Sacchi
- Orthopedics and Traumatology Residency in Università degli Studi Di Brescia, Brescia, Italy.
| | - Davide Boeris
- Neurosurgery Unit, Neurosurgery Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Fabio Giuseppe Villa
- Neurosurgery Unit, Neurosurgery Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Federico Bove
- Orthopedics and Traumatology Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Francesco Puglia
- Orthopedics and Traumatology Unit, Pediatric Orthopedics and Traumatology Department, Milan, Italy
| | - Giuseppe Rosario Schirò
- Orthopedics and Traumatology Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| |
Collapse
|
2
|
Aprato A, Branca Vergano L, Casiraghi A, Liuzza F, Mezzadri U, Balagna A, Prandoni L, Rohayem M, Sacchi L, Smakaj A, Arduini M, Are A, Battiato C, Berlusconi M, Bove F, Cattaneo S, Cavanna M, Chiodini F, Commessatti M, Addevico F, Erasmo R, Ferreli A, Galante C, Giorgi PD, Lamponi F, Moghnie A, Oransky M, Panella A, Pascarella R, Santolini F, Schiro GR, Stella M, Zoccola K, Massé A. Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures. J Orthop Traumatol 2023; 24:46. [PMID: 37665518 PMCID: PMC10477162 DOI: 10.1186/s10195-023-00726-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND There is no evidence in the current literature about the best treatment option in sacral fracture with or without neurological impairment. MATERIALS AND METHODS The Italian Pelvic Trauma Association (A.I.P.) decided to organize a consensus to define the best treatment for traumatic and insufficiency fractures according to neurological impairment. RESULTS Consensus has been reached for the following statements: When complete neurological examination cannot be performed, pelvic X-rays, CT scan, hip and pelvis MRI, lumbosacral MRI, and lower extremities evoked potentials are useful. Lower extremities EMG should not be used in an acute setting; a patient with cauda equina syndrome associated with a sacral fracture represents an absolute indication for sacral reduction and the correct timing for reduction is "as early as possible". An isolated and incomplete radicular neurological deficit of the lower limbs does not represent an indication for laminectomy after reduction in the case of a displaced sacral fracture in a high-energy trauma, while a worsening and progressive radicular neurological deficit represents an indication. In the case of a displaced sacral fracture and neurological deficit with imaging showing no evidence of nerve root compression, a laminectomy after reduction is not indicated. In a patient who was not initially investigated from a neurological point of view, if a clinical investigation conducted after 72 h identifies a neurological deficit in the presence of a displaced sacral fracture with nerve compression on MRI, a laminectomy after reduction may be indicated. In the case of an indication to perform a sacral decompression, a first attempt with closed reduction through external manoeuvres is not mandatory. Transcondylar traction does not represent a valid method for performing a closed decompression. Following a sacral decompression, a sacral fixation (e.g. sacroiliac screw, triangular osteosynthesis, lumbopelvic fixation) should be performed. An isolated and complete radicular neurological deficit of the lower limbs represents an indication for laminectomy after reduction in the case of a displaced sacral fracture in a low-energy trauma associated with imaging suggestive of root compression. An isolated and incomplete radicular neurological deficit of the lower limbs does not represent an absolute indication. A worsening and progressive radicular neurological deficit of the lower limbs represents an indication for laminectomy after reduction in the case of a displaced sacral fracture in a low-energy trauma associated with imaging suggestive of root compression. In the case of a displaced sacral fracture and neurological deficit in a low-energy trauma, sacral decompression followed by surgical fixation is indicated. CONCLUSIONS This consensus collects expert opinion about this topic and may guide the surgeon in choosing the best treatment for these patients. LEVEL OF EVIDENCE IV. TRIAL REGISTRATION not applicable (consensus paper).
Collapse
Affiliation(s)
- Alessandro Aprato
- Università degli studi di Torino, Viale 25 Aprile 137 Int 6, 10133, Turin, Italy.
| | | | | | | | - Umberto Mezzadri
- ASST Grande Ospedale Metropolitano Niguarda di Milano, Milan, Italy
| | - Alberto Balagna
- Università degli studi di Torino, Viale 25 Aprile 137 Int 6, 10133, Turin, Italy
| | | | | | | | | | | | | | | | | | - Federico Bove
- ASST Grande Ospedale Metropolitano Niguarda di Milano, Milan, Italy
| | | | | | | | | | | | - Rocco Erasmo
- Ospedale Civile Santo Spirito di Pescara, Pescara, Italy
| | | | | | | | | | | | - Michel Oransky
- Università degli studi di Roma, ASST degli spedali Civili di Brescia, Brescia, Italy
| | | | | | | | | | | | | | - Alessandro Massé
- Università degli studi di Torino, Viale 25 Aprile 137 Int 6, 10133, Turin, Italy
| |
Collapse
|
3
|
De Amici M, Barocci F, Barzaghi CE, Sacchi L, De Silvestri A, Licari A, Caimmi S, Marseglia A, Testa G, Torre C, Marseglia GL. Impact of individual molecular components in determining primary sensitization to latex. Immunobiology 2023; 228:152320. [PMID: 36621307 DOI: 10.1016/j.imbio.2022.152320] [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: 06/21/2022] [Revised: 10/01/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023]
Abstract
Allergy to natural rubber latex emerged as one of the main allergies at the beginning among some professional groups and the general population. Sensitization and development of latex allergy have been attributed to exposure to products containing residual latex proteins. The prevailing cross-reactivity of latex proteins with other food allergens is of great concern. Numerous purified allergens are currently available, which greatly help in patient management, thus determining their specific profile. We conducted a multicenter study to investigate changes, from the ROC analysis, in the characteristics of patients with latex allergy by measuring its major protein components. Sensitization to latex proteins is crucial because it highlights the cross reactivity to inhalants (pollen) and food (fruit). It is very essential in an accurate and specific clinical setting.
Collapse
Affiliation(s)
- M De Amici
- Immuno-Allergology Laboratory of Clinical Chemistry and Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Barocci
- Medicine Unit Laboratory, ASST Rhodense Garbagnate Milanese, Rho, Italy.
| | - C E Barzaghi
- Allergology Clinic, ASST Rhodense Garbagnate Milanese, Rho, Italy
| | - L Sacchi
- Laboratory for Biomedical Informatics "Mario Stefanelli", Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy
| | - A De Silvestri
- Servizio di Epidemiologia Clinica e Biometria Direzione Scientifica - Fondazione IRCCS Policlinico san Matteo, Pavia, Italy
| | - A Licari
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Caimmi
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Testa
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Torre
- Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G L Marseglia
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
4
|
Buonocore TM, Parimbelli E, Sacchi L, Bellazzi R, Del Campo L, Quaglini S. Improving Keyword-Based Topic Classification in Cancer Patient Forums with Multilingual Transformers. Stud Health Technol Inform 2022; 290:597-601. [PMID: 35673086 DOI: 10.3233/shti220147] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Online forums play an important role in connecting people who have crossed paths with cancer. These communities create networks of mutual support that cover different cancer-related topics, containing an extensive amount of heterogeneous information that can be mined to get useful insights. This work presents a case study where users' posts from an Italian cancer patient community have been classified combining both count-based and prediction-based representations to identify discussion topics, with the aim of improving message reviewing and filtering. We demonstrate that pairing simple bag-of-words representations based on keywords matching with pre-trained contextual embeddings significantly improves the overall quality of the predictions and allows the model to handle ambiguities and misspellings. By using non-English real-world data, we also investigated the reusability of pretrained multilingual models like BERT in lower data regimes like many local medical institutions.
Collapse
Affiliation(s)
- T M Buonocore
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - E Parimbelli
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - L Sacchi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - R Bellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - L Del Campo
- AIMAC, Italian Association of Cancer patients, relatives and friends, Rome, Italy
| | - S Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| |
Collapse
|
5
|
Marinaro S, Sacchi L, Gasparri N. From whom and for what? Deforestation in Dry Chaco from local-urban inhabitants’ perception. Perspect Ecol Conserv 2022. [DOI: 10.1016/j.pecon.2021.12.003] [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: 10/19/2022] Open
|
6
|
Clericò M, Broggi R, Sacchi L, Agliardi E. A clinical report of a maxillary All-on-4 rehabilitation with a proposed EMG protocol. J BIOL REG HOMEOS AG 2020; 34:81-90. [PMID: 33412783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- M Clericò
- Doctor of Dental Medicine in Milan, Italy
| | - R Broggi
- Department of Dentistry, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| | - L Sacchi
- Doctor of Dental Medicine in Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| | - E Agliardi
- Department of Dentistry, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
- Chief of special rehabilitation surgery Department of Dentistry S. Raffaele Hospital, Milan, Italy
| |
Collapse
|
7
|
Tetè G, Sacchi L, Camerano C, Nagni M, Capelli O, Giuntoli Vercellin S, La Rocca G, Polizzi E. Management of the delicate phase of the temporary crown: an in vitro study. J BIOL REG HOMEOS AG 2020; 34:69-80. [PMID: 33412782] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The fundamental moment of prosthetic rehabilitation is the "temporary". Although the meaning of the term diminishes its importance, the provisional has fundamental biological, aesthetic and functional functions. The oral cavity must maintain an adequate level of oral hygiene to carry out this delicate phase in the best possible way; a result achieved only with the collaboration of the prosthetic dentist with the hygienist and the patient, as if they were a biological system in motion. The different methods of hygiene are effective in maintaining a good level of oral health; but they could, if too aggressive, affect the prosthetic restoration. Our objective in vitro is to understand, after applying a known bacterial load, which hygiene method is the most effective in removing bacterial biofilm but at the same time is less aggressive towards resinous material.
Collapse
Affiliation(s)
- G Tetè
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| | - L Sacchi
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| | | | - M Nagni
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| | - O Capelli
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| | - S Giuntoli Vercellin
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| | - G La Rocca
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| | - E Polizzi
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita Salute University, Milan, Italy
| |
Collapse
|
8
|
Tetè G, Cisternino L, Giorgio G, Sacchi L, Montemezzi P, Sannino G. Immediate versus delayed loading of post-extraction implants in the aesthetic zone: a prospective longitudinal study with 4-year follow-up. J BIOL REG HOMEOS AG 2020; 34:19-25. [PMID: 33386053] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of this randomized clinical trial was to compare the outcome of immediate versus delayedloading protocol using a new conical connection implant in post-extractive sockets with 4-year followup. Patients requiring single-tooth extraction for root fractures or periodontal disease in the maxillary or mandibular anterior or premolar areas were selected for the present study. After extraction, implants were placed immediately in fresh sockets. After randomization process, in group A immediate loading was performed while in group B a delayed loading protocol was followed. In both groups mean marginal bone loss was measured through intraoral digital radiographs at 3, 6, 12, 24, 36 and 48 months from loading. After a 48-month follow-up period, a success and survival rate of 96.55% was found in both groups. At 48-month follow-up, for group A a mean marginal bone loss of 0.14 ± 0.15mm was found, while for group B a value of 0.12 ± 0.12 mm was measured. No statistically significant differences between groups were found at each time point (P>0.05). When used in post-extractive immediate and delayed loading implant rehabilitations, the new conical connection implant showed a predictable outcome at 48-month follow-up. However, further clinical studies are needed to evaluate soft tissues adaptation, patient satisfaction, and long-term follow-up.
Collapse
Affiliation(s)
- G Tetè
- Specialization School in Oral Surgery, Vita-Salute University, Milan, Italy
| | - L Cisternino
- Specialization School in Oral Surgery, Vita-Salute University, Milan, Italy
| | - G Giorgio
- Dental School, Vita-Salute University, Milan, Italy
| | - L Sacchi
- Dental School, Vita-Salute University, Milan, Italy
| | - P Montemezzi
- DDS, PhD, Consultant, Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - G Sannino
- DDS, PhD, Consultant, Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| |
Collapse
|
9
|
Romeo D, Sacchi L, Fuchs F, Tetè G, Agliardi E. Experimental analysis of the influence of cortical bone layers and bone quantity on implant primary stability. J BIOL REG HOMEOS AG 2020; 34:47-57. [PMID: 33412780] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The systematic analysis of parameters impacting implant primary stability is difficult to achieve with human cadavers or animal models, particularly for complex trans-sinus procedures to determine the effects of cortical layers and bone engagement on implant stability before and after a simulated load in vitro. Solid rigid polyurethane blocks, partially intersected by an 8-mm-thick space, were created to imitate tri-cortical situations, the presence of the sinus cavity, and the posterior maxilla with different degrees of bone atrophy. Implants were inserted through the cavity at an angle of 30˚ (scenarios 1 and 2) to imitate the clinical protocol. Controls simulating uni-cortical anchorage and no sinus cavity were also included (controls 1 and 2). Four parameters were measured: peak insertion torque, insertion work, resistance to lateral bending loads and extraction torque. Scenarios 1 and 2 displayed similar peak insertion torque to control 2, where all three groups anchored equal amounts of bone surrogate. The distribution of surrogate bone in contact with trans-cavity implants influenced both extraction torque and the degree of lateral bending. Sufficient peak insertion torque can be attained with a trans-sinus tricortical implant anchorage providing sufficient apical and coronal bone is engaged.
Collapse
Affiliation(s)
- D Romeo
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milano, Italy
| | - L Sacchi
- Dental School, Vita Salute San Raffaele University, Milan, Italy and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - F Fuchs
- Biomechanics, Nobel Biocare Services AG, Kloten, Switzerland
| | - G Tetè
- Dental School, Vita Salute San Raffaele University, Milan, Italy and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - E Agliardi
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milano, Italy
| |
Collapse
|
10
|
De Amici M, Ciprandi G, Caimmi S, Sacchi L, Licari A, Barocci F, Testa G, Marseglia GL. Cross reactivity between recombinant parvalbumin of carp and cod and recombinant grass molecules. J BIOL REG HOMEOS AG 2019; 33:1931-1933. [PMID: 31928595 DOI: 10.23812/19-235-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- M De Amici
- Laboratory Immuno-Allergology of Clinical Chemistry and Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, Pavia, Italy
| | - G Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
| | - S Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, University of Pavia, Pavia, Italy
| | - L Sacchi
- Laboratory for Biomedical Informatics "Mario Stefanelli", Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - A Licari
- Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, University of Pavia, Pavia, Italy
| | - F Barocci
- Laboratory Medicine Unit, ASST Rhodense, Garbagnate Milanese, Italy
| | - G Testa
- Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, University of Pavia, Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, University of Pavia, Pavia, Italy
| |
Collapse
|
11
|
Chiudinelli L, Gabetta M, Centorrino G, Viani N, Tasca C, Zambelli A, Bucalo M, Ghirardi A, Barbarini N, Sfreddo E, Tondini C, Bellazzi R, Sacchi L. Ontology-Driven Real World Evidence Extraction from Clinical Narratives. Stud Health Technol Inform 2019; 264:1441-1442. [PMID: 31438171 DOI: 10.3233/shti190474] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Unstructured clinical notes contain a huge amount of information. We investigated the possibility of harvesting such information through an NLP-based approach. A manually curated ontology is the only resource required to handle all the steps of the process leading from clinical narrative to a structured data warehouse (i2b2). We have tested our approach at the Papa Giovanni XXIII hospital in Bergamo (Italy) on pathology reports collected since 2008.
Collapse
Affiliation(s)
- L Chiudinelli
- Laboratory for Biomedical Informatics "Mario Stefanelli", University of Pavia, Italy.,Hospital "ASST Papa Giovanni XXIII", Bergamo, Italy
| | - M Gabetta
- BIOMERIS (BIOMEdical Research Informatics Solutions), Pavia, Italy
| | - G Centorrino
- BIOMERIS (BIOMEdical Research Informatics Solutions), Pavia, Italy
| | - N Viani
- Laboratory for Biomedical Informatics "Mario Stefanelli", University of Pavia, Italy.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C Tasca
- Hospital "ASST Papa Giovanni XXIII", Bergamo, Italy
| | - A Zambelli
- Hospital "ASST Papa Giovanni XXIII", Bergamo, Italy
| | - M Bucalo
- BIOMERIS (BIOMEdical Research Informatics Solutions), Pavia, Italy
| | - A Ghirardi
- Hospital "ASST Papa Giovanni XXIII", Bergamo, Italy
| | - N Barbarini
- BIOMERIS (BIOMEdical Research Informatics Solutions), Pavia, Italy
| | - E Sfreddo
- Hospital "ASST Papa Giovanni XXIII", Bergamo, Italy
| | - C Tondini
- Hospital "ASST Papa Giovanni XXIII", Bergamo, Italy
| | - R Bellazzi
- Laboratory for Biomedical Informatics "Mario Stefanelli", University of Pavia, Italy
| | - L Sacchi
- Laboratory for Biomedical Informatics "Mario Stefanelli", University of Pavia, Italy
| |
Collapse
|
12
|
Parimbelli E, Marini S, Sacchi L, Bellazzi R. Patient similarity for precision medicine: A systematic review. J Biomed Inform 2018; 83:87-96. [PMID: 29864490 DOI: 10.1016/j.jbi.2018.06.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [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: 01/31/2018] [Revised: 05/16/2018] [Accepted: 06/01/2018] [Indexed: 12/19/2022]
Abstract
Evidence-based medicine is the most prevalent paradigm adopted by physicians. Clinical practice guidelines typically define a set of recommendations together with eligibility criteria that restrict their applicability to a specific group of patients. The ever-growing size and availability of health-related data is currently challenging the broad definitions of guideline-defined patient groups. Precision medicine leverages on genetic, phenotypic, or psychosocial characteristics to provide precise identification of patient subsets for treatment targeting. Defining a patient similarity measure is thus an essential step to allow stratification of patients into clinically-meaningful subgroups. The present review investigates the use of patient similarity as a tool to enable precision medicine. 279 articles were analyzed along four dimensions: data types considered, clinical domains of application, data analysis methods, and translational stage of findings. Cancer-related research employing molecular profiling and standard data analysis techniques such as clustering constitute the majority of the retrieved studies. Chronic and psychiatric diseases follow as the second most represented clinical domains. Interestingly, almost one quarter of the studies analyzed presented a novel methodology, with the most advanced employing data integration strategies and being portable to different clinical domains. Integration of such techniques into decision support systems constitutes and interesting trend for future research.
Collapse
Affiliation(s)
- E Parimbelli
- Telfer School of Management, University of Ottawa, Ottawa, Canada; Interdepartmental Centre for Health Technologies, University of Pavia, Italy.
| | - S Marini
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, USA; Interdepartmental Centre for Health Technologies, University of Pavia, Italy
| | - L Sacchi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy; Interdepartmental Centre for Health Technologies, University of Pavia, Italy
| | - R Bellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy; Interdepartmental Centre for Health Technologies, University of Pavia, Italy; RCCS ICS Maugeri, Pavia, Italy
| |
Collapse
|
13
|
Martinez-Millana A, Fernandez-Llatas C, Sacchi L, Segagni D, Guillen S, Bellazzi R, Traver V. From data to the decision: A software architecture to integrate predictive modelling in clinical settings. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2015:8161-4. [PMID: 26738188 DOI: 10.1109/embc.2015.7320288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The application of statistics and mathematics over large amounts of data is providing healthcare systems with new tools for screening and managing multiple diseases. Nonetheless, these tools have many technical and clinical limitations as they are based on datasets with concrete characteristics. This proposition paper describes a novel architecture focused on providing a validation framework for discrimination and prediction models in the screening of Type 2 diabetes. For that, the architecture has been designed to gather different data sources under a common data structure and, furthermore, to be controlled by a centralized component (Orchestrator) in charge of directing the interaction flows among data sources, models and graphical user interfaces. This innovative approach aims to overcome the data-dependency of the models by providing a validation framework for the models as they are used within clinical settings.
Collapse
|
14
|
Sacchi L, Rubrichi S, Mazzanti A, Quaglini S, Parimbelli E. UceWeb: a Web-based Collaborative Tool for Collecting and Sharing Quality of Life Data. Methods Inf Med 2018; 54:156-63. [DOI: 10.3414/me14-01-0021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 10/01/2014] [Indexed: 11/09/2022]
Abstract
SummaryObjectives: This work aims at building a platform where quality-of-life data, namely utility coefficients, can be elicited not only for immediate use, but also systematically stored together with patient profiles to build a public repository to be further exploited in studies on specific target populations (e.g. cost/utility analyses).Methods: We capitalized on utility theory and previous experience to define a set of desirable features such a tool should show to facilitate sound elicitation of quality of life. A set of visualization tools and algorithms has been developed to this purpose. To make it easily accessible for potential users, the software has been designed as a web application. A pilot validation study has been performed on 20 atrial fibrillation patients.Results: A collaborative platform, UceWeb, has been developed and tested. It implements the standard gamble, time trade-off and rating-scale utility elicitation methods. It allows doctors and patients to choose the mode of interaction to maximize patients’ comfort in answering difficult questions. Every utility elicitation may contribute to the growth of the repository.Conclusion: UceWeb can become a unique source of data allowing researchers both to perform more reliable comparisons among healthcare interventions and build statistical models to gain deeper insight into quality of life data.
Collapse
|
15
|
Abstract
Objectives: To identify common methodological challenges and review relevant initiatives related to the re-use of patient data collected in routine clinical care, as well as to analyze the economic benefits derived from the secondary use of this data. Through the use of several examples, this article aims to provide a glimpse into the different areas of application, namely clinical research, genomic research, study of environmental factors, and population and health services research. This paper describes some of the informatics methods and Big Data resources developed in this context, such as electronic phenotyping, clinical research networks, biorepositories, screening data banks, and wide association studies. Lastly, some of the potential limitations of these approaches are discussed, focusing on confounding factors and data quality. Methods: A series of literature searches in main bibliographic databases have been conducted in order to assess the extent to which existing patient data has been repurposed for research. This contribution from the IMIA working group on "Data mining and Big Data analytics" focuses on the literature published during the last two years, covering the timeframe since the working group's last survey. Results and Conclusions: Although most of the examples of secondary use of patient data lie in the arena of clinical and health services research, we have started to witness other important applications, particularly in the area of genomic research and the study of health effects of environmental factors. Further research is needed to characterize the economic impact of secondary use across the broad spectrum of translational research.
Collapse
Affiliation(s)
- F. J. Martin-Sanchez
- Weill Cornell Medicine, Department of Healthcare Policy and Research, Division of Health Informatics, New York, USA
| | - V. Aguiar-Pulido
- Weill Cornell Medicine, Brain and Mind Research Institute, New York, USA
| | - G. H. Lopez-Campos
- The University of Melbourne, Health & Biomedical Informatics Centre, Melbourne, Australia
| | - N. Peek
- MRC Health e-Research Centre, Division of Informatics, Imaging and Data Science, The University of Manchester, Manchester, UK
| | - L. Sacchi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| |
Collapse
|
16
|
Abstract
OBJECTIVES This survey aims at highlighting the latest trends (2012-2014) on the development, use, and evaluation of Information and Communication Technologies (ICT) based decision support systems (DSSs) in medicine, with a particular focus on patient-centered and personalized care. METHODS We considered papers published on scientific journals, by querying PubMed and Web of ScienceTM. Included studies focused on the implementation or evaluation of ICT-based tools used in clinical practice. A separate search was performed on computerized physician order entry systems (CPOEs), since they are increasingly embedding patient-tailored decision support. RESULTS We found 73 papers on DSSs (53 on specific ICT tools) and 72 papers on CPOEs. Although decision support through the delivery of recommendations is frequent (28/53 papers), our review highlighted also DSSs only based on efficient information presentation (25/53). Patient participation in making decisions is still limited (9/53), and mostly focused on risk communication. The most represented medical area is cancer (12%). Policy makers are beginning to be included among stakeholders (6/73), but integration with hospital information systems is still low. Concerning knowledge representation/management issues, we identified a trend towards building inference engines on top of standard data models. Most of the tools (57%) underwent a formal assessment study, even if half of them aimed at evaluating usability and not effectiveness. CONCLUSIONS Overall, we have noticed interesting evolutions of medical DSSs to improve communication with the patient, consider the economic and organizational impact, and use standard models for knowledge representation. However, systems focusing on patient-centered care still do not seem to be available at large.
Collapse
Affiliation(s)
- S Quaglini
- Silvana Quaglini, Department of Electrical, Computer, and Biomedical Engineering, University of Pavia, Via Ferrata 5, 27100 Pavia, Italy, Tel: +39 0382 985058, Fax: +39 0382 985060, E-mail:
| | | | | | | |
Collapse
|
17
|
Abstract
OBJECTIVES We sought to explore, via a systematic review of the literature, the state of the art of knowledge discovery in biomedical databases as it existed in 1992, and then now, 25 years later, mainly focused on supervised learning. METHODS We performed a rigorous systematic search of PubMed and latent Dirichlet allocation to identify themes in the literature and trends in the science of knowledge discovery in and between time periods and compare these trends. We restricted the result set using a bracket of five years previous, such that the 1992 result set was restricted to articles published between 1987 and 1992, and the 2015 set between 2011 and 2015. This was to reflect the current literature available at the time to researchers and others at the target dates of 1992 and 2015. The search term was framed as: Knowledge Discovery OR Data Mining OR Pattern Discovery OR Pattern Recognition, Automated. RESULTS A total 538 and 18,172 documents were retrieved for 1992 and 2015, respectively. The number and type of data sources increased dramatically over the observation period, primarily due to the advent of electronic clinical systems. The period 1992- 2015 saw the emergence of new areas of research in knowledge discovery, and the refinement and application of machine learning approaches that were nascent or unknown in 1992. CONCLUSIONS Over the 25 years of the observation period, we identified numerous developments that impacted the science of knowledge discovery, including the availability of new forms of data, new machine learning algorithms, and new application domains. Through a bibliometric analysis we examine the striking changes in the availability of highly heterogeneous data resources, the evolution of new algorithmic approaches to knowledge discovery, and we consider from legal, social, and political perspectives possible explanations of the growth of the field. Finally, we reflect on the achievements of the past 25 years to consider what the next 25 years will bring with regard to the availability of even more complex data and to the methods that could be, and are being now developed for the discovery of new knowledge in biomedical data.
Collapse
Affiliation(s)
| | - J H Holmes
- John H Holmes, Institute for Biomedical Informatics, University of Pennsylvania School of Medicine, 717 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA, Tel: 215-898-4833, Fax: 215-573-5325, E-Mail:
| |
Collapse
|
18
|
Beretta L, Sacchi L, Calvi M, Cenzato M. Intensive Care Management of Patients with Subarachnoid Hemorrhage at San Raffaele Hospital, Milan. Interv Neuroradiol 2016; 1:65-70. [DOI: 10.1177/159101999500100109] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/1995] [Accepted: 09/10/1995] [Indexed: 11/16/2022] Open
Abstract
Intensive care of patients with SAH is targeted to recognize and treat the leading cause of death and disability. Hemorrhage, vasospasm, rebleeding, intracranial hypertension can produce ischaemia because the ratio between metabolism (CMRO2) and cerebral blood flow (CBF) is not coupled. Neuro-ICU bedside monitoring provides information on the intracranial dynamics. Aggressive treatment attempts to avoid ischaemia but needs a clipped or thrombosed (via endovascular approach) aneurysm. The authors propose treatment to improve CBF and reduce CMRO2: hypervolemia, hemodilution, hypertension, ICP reduction, normocapnia, mannitol infusion, normothermia or mild hypothermia and sedation with intravenous anaesthetics. Medical complications such as hypovolemia, infections, pulmonary oedema, gastrointestinal bleeding need to be recognized early and treated.
Collapse
Affiliation(s)
| | | | | | - M. Cenzato
- Neurosurgery, Scientific Institute Hospital S. Raffaele; Milan, Italy
| |
Collapse
|
19
|
Sacchi L, Dagliati A, Tibollo V, Leporati P, De Cata P, Cerra C, Chiovato L, Bellazzi R. Template for preparation of papers for IEEE sponsored conferences & symposia. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:2123-6. [PMID: 26736708 DOI: 10.1109/embc.2015.7318808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To improve the access to medical information is necessary to design and implement integrated informatics techniques aimed to gather data from different and heterogeneous sources. This paper describes the technologies used to integrate data coming from the electronic medical record of the IRCCS Fondazione Maugeri (FSM) hospital of Pavia, Italy, and combines them with administrative, pharmacy drugs purchase coming from the local healthcare agency (ASL) of the Pavia area and environmental open data of the same region. The integration process is focused on data coming from a cohort of one thousand patients diagnosed with Type 2 Diabetes Mellitus (T2DM). Data analysis and temporal data mining techniques have been integrated to enhance the initial dataset allowing the possibility to stratify patients using further information coming from the mined data like behavioral patterns of prescription-related drug purchases and other frequent clinical temporal patterns, through the use of an intuitive dashboard controlled system.
Collapse
|
20
|
Sancini A, Caciari T, Chighine A, Gioffrè PA, Andreozzi G, Sacchi L, Giubilati R, Tomei G, Suppi A, Sacco C, Tomei F, Rosati MV. Workers of the printing industry and hepatic damage. Ann Ig 2014; 26:321-329. [PMID: 25001122 DOI: 10.7416/ai.2014.1992] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Typesetting industry is still the primary instrument of communication, despite the development of new technological systems. This study focuses on the analysis of the hepatic effects induced by the use of some organic solvents employed in the printing industry. METHODS We studied a group of 194 workers: 93 exposed and 101 not exposed. The level of the exposure to chemical pollutants were assessed through the environmental monitoring of blood concentrations and the analysis of airborne substances. The health survey was performed through the collection of the medical history and the use of hepatic tests, which were evaluated by calculating Mean, Standard Deviation, Student's t-test and X² test with Yates Correction, to investigate statistically significant differences in some hepatic parameters: AST, ALT, ALP, GGT, fractional and total bilirubin. The environmental data sometimes exceeded the TLV-TWA. RESULTS The clinical evaluation of the hepatic parameters showed statistically significant differences as to the hematic concentrations of AST, ALT, GGT. CONCLUSIONS The results we obtained support the hypothesis of a risk among the printing industrial workers attributable to the hepatotoxic solvents. This risk seems to be related to the use of a mixture of solvents, although at low doses, and the analysis of the results obtained confirms the validity of the investigation for the health screening protocol adopted in order to identify subjects and/or population at risk of hepatotoxicity.
Collapse
Affiliation(s)
- A Sancini
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - T Caciari
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - A Chighine
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - P A Gioffrè
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - G Andreozzi
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - L Sacchi
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - R Giubilati
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - G Tomei
- Department of Psychiatric and Psychological Science, Sapienza University of Rome, Italy
| | - A Suppi
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - C Sacco
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - F Tomei
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| | - M V Rosati
- Department of Anatomy, Histology, Legal Medicine and Orthopedics, Unit of Occupational Medicine, Sapienza University of Rome, Italy
| |
Collapse
|
21
|
Merico V, Zuccotti M, Carpi D, Baev D, Mulas F, Sacchi L, Bellazzi R, Pastorelli R, Redi CA, Moratti R, Garagna S, Balduini A. The genomic and proteomic blueprint of mouse megakaryocytes derived from embryonic stem cells. J Thromb Haemost 2012; 10:907-15. [PMID: 22372922 DOI: 10.1111/j.1538-7836.2012.04673.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 12/29/2022]
Abstract
BACKGROUND Platelets are specialized cells, produced by megakaryocytes (MKs) in the bone marrow, which represent the first defense against hemorrhage. There are many diseases where platelet production or function is impaired, with severe consequences for patients. Therefore, new insights into the process of MK differentiation and platelet formation would have a major impact on both basic and clinical research. OBJECTIVES Embryonic stem (ES) cells represent a good in vitro model to study the differentiation of MKs, with the possibility of being genetically engineered and constituting an unlimited source of MKs. However, lack of knowledge about the molecular identity of ES-derived MKs (ES-MKs) may prevent any further development and application of this model. METHODS This paper presents the first comprehensive transcriptional and proteome profile analyses of mouse ES-MKs in comparison with MKs derived from mouse fetal liver progenitors (FL-MKs). RESULTS In ES-MKs we found a down-regulation of cytoskeleton proteins, specific transcription factors and membrane receptors at both transcriptional and protein levels. At the phenotypic level, this molecular blueprint was displayed by ES-MKs' lower polyploidy, lower nuclear/cytoplasm ratio and reduced capacity to form proplatelets and releasing platelets. CONCLUSIONS Overall our data demonstrate that ES-MKs represent a useful model to clarify many aspects of both MK physiology and pathological conditions where impaired MK functions are related to defective MK development, as in inherited thrombocytopenias and primary myelofibrosis.
Collapse
Affiliation(s)
- V Merico
- Laboratorio di Biologia dello Sviluppo, Dipartimento di Biologia e Biotecnologie Lazzaro Spallanzani, University of Pavia, Pavia, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Concaro S, Sacchi L, Cerra C, Fratino P, Bellazzi R. Mining health care administrative data with temporal association rules on hybrid events. Methods Inf Med 2010; 50:166-79. [PMID: 21170468 DOI: 10.3414/me10-01-0036] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 09/16/2010] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The analysis of administrative health care data can be helpful to conveniently assess health care activities. In this context temporal data mining techniques can be suitably exploited to get a deeper insight into the processes underlying health care delivery. In this paper we present an algorithm for the extraction of temporal association rules (TARs) on sequences of hybrid events and its application on health care administrative databases. METHODS We propose a method that extends TAR mining by managing hybrid events, namely events characterized by a heterogeneous temporal nature. Hybrid events include both point-like events (e.g. ambulatory visits) and interval-like events (e.g. drug consumption). The definition of user-defined rule templates can be optionally used to constrain the search only to the extraction of a subset of interesting rules. A TAR post-pruning strategy, based on a case-control approach, is also presented. RESULTS We analyzed the administrative database of diabetic patients in charge to the regional health care agency (ASL) of Pavia. TAR mining allowed to find patterns specifically related to the diabetic population in comparison with a control group, as well as to check the compliance of the actual clinical careflow with the ASL recommendations. CONCLUSION The experimental results highlighted the main potentials of the algorithm, such as the opportunity to detect interesting temporal relationships between diagnostic or therapeutic patterns, or to check the adherence of past temporal behaviors to specific expected paths (e.g. guidelines) or to discover new knowledge that could be implicitly hidden in the data.
Collapse
Affiliation(s)
- S Concaro
- Dipartimento di Informatica e Sistemistica, Università di Pavia, Pavia, Italy
| | | | | | | | | |
Collapse
|
23
|
Mukaratirwa S, Dzoma BM, Matenga E, Ruziwa SD, Sacchi L, Pozio E. Experimental infections of baboons ( Papio spp.) and vervet monkeys ( Cercopithecus aethiops) with Trichinella zimbabwensis and successful treatment with ivermectin. ACTA ACUST UNITED AC 2008. [DOI: 10.4102/ojvr.v75i2.16] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Experimental Trichinella zimbabwensis infections were established in three baboons (Papios p.)and four vervet monkeys (Cercopithecuase thiops) and the clinical-pathological manifestations assessed. The infected animals showed clinical signs ranging from fever, diarrhoea, periorbitaol edema and muscular pain in varying degrees. One baboon became blind due to the infection. Levels of creatinine phosphokinase and lactated ehydrogenase increased to reach a peak on Day 42 post-infection(pi)for both baboons and monkeys. Blood parameters such as packed cell volume, levels of red blood cells and white blood cells did not change significantly from the normal ranges except for the levels of eosinophils which peaked above the normal ranges at Day 28 and 56 pi in baboons and at Day 56 pi in monkeys.
Collapse
|
24
|
Sacchi L, Genchi M, Clementi E, Bigliardi E, Avanzati A, Pajoro M, Negri I, Marzorati M, Gonella E, Alma A, Daffonchio D, Bandi C. Multiple symbiosis in the leafhopper Scaphoideus titanus (Hemiptera: Cicadellidae): Details of transovarial transmission of Cardinium sp. and yeast-like endosymbionts. Tissue Cell 2008; 40:231-42. [DOI: 10.1016/j.tice.2007.12.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Revised: 12/14/2007] [Accepted: 12/18/2007] [Indexed: 10/22/2022]
|
25
|
Mukaratirwa S, Dzoma BM, Matenga E, Ruziwa SD, Sacchi L, Pozio E. Experimental infections of baboons (Papio spp.) and vervet monkeys (Cercopithecus aethiops) with Trichinella zimbabwensis and successful treatment with ivermectin. Onderstepoort J Vet Res 2008; 75:173-180. [PMID: 18788211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Experimental Trichinella zimbabwensis infections were established in three baboons (Papio sp.) and four vervet monkeys (Cercopithecus aethiops) and the clinical-pathological manifestations assessed. The infected animals showed clinical signs ranging from fever, diarrhoea, periorbital oedema and muscular pain in varying degrees. One baboon became blind due to the infection. Levels of creatinine phosphokinase and lactate dehydrogenase increased to reach a peak on Day 42 post-infection (pi) for both baboons and monkeys. Blood parameters such as packed cell volume, levels of red blood cells and white blood cells did not change significantly from the normal ranges except for the levels of eosinophils which peaked above the normal ranges at Day 28 and 56 pi in baboons and at Day 56 pi in monkeys. Two baboons and two monkeys died during the course of the experiment. They were emaciated and showed lesions such as ascites, hydropericardium, congested liver and enlarged gall bladder. Histopathological findings of various muscles included a basophilic transformation of muscle cells, the disappearance of sarcomere myofibrils and basophilic sarcoplasm with the presence of Trichinella larvae in the sarcoplasm. These changes were mainly in the massetter and were of various intensities in the tail, gastrocnemius and biceps muscles. Five consecutive treatments with an oxfendazole-levamisole combination on surviving animals failed to clear the infection whereas ivermectin cleared the infection after one treatment in two monkeys and after two treatments in a baboon.
Collapse
Affiliation(s)
- S Mukaratirwa
- Department of Paraclinical Veterinary Studies, Faculty of Veterinary Science, University of Zimbabwe, P.O. Box MP 167 Mount Pleasant Harare, Zimbabwe.
| | | | | | | | | | | |
Collapse
|
26
|
Monti C, Bacaloni A, D'Onofrio A, Fiaschetti M, Filippelli C, Tomei F, Sacchi L, Vacca D, Tomei G, Giubilati R, Casale T, Pimpinella B, Sordello G, Tomei F. [Assessment of the cancerogenic risk in schools]. Ann Ig 2008; 20:27-38. [PMID: 18478674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of the study is to verify the presence of the carcinogenic risk for teachers, technical assistants and students in 96 secondary schools, providing suggestions for its assessment. Since the analysis of the national and international scientific literature does not reveal data on the evaluation of the carcinogenic risk nor in schools nor in similar environments, the authors gave importance to the preliminary phase of the risk assessment that is to say the inspections aimed to detect the possible presence of risk agents and to identify the possible exposed subjects. The evaluation of the exposition through the execution of environmental and biological monitoring has to be performed, according to the authors opinion, only after this indispensable preliminary phase. The carcinogenic risk has been ascertained in relation to the presence of substances used for didactical means (fuels, mineral oils, reagents, enamels and pitch, ceramic mixtures and metallic alloys) or produced during practical activities (hard wood dusts, Polycyclic Aromatic Hydrocarbons (PAHs) deriving from high temperatures cooking), analyzing the tasks implying their use and identifying the exposed subjects. The presence of carcinogenic agents has been found out in 54 on 96 schools. In order to preserve the health status of the exposed workers in schools, it is necessary the adoption of the suitable measures of prevention and protection similarly to what is established for all the work places, even before the eventual environmental monitoring.
Collapse
Affiliation(s)
- C Monti
- Cattedra e Scuola di Specializzazione in Medicina del Lavoro, Sapienza Università di Roma
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Bigliardi E, Sacchi L, Genchi M, Alma A, Pajoro M, Daffonchio D, Marzorati M, Avanzati AM. Ultrastructure of a novel Cardinium sp. symbiont in Scaphoideus titanus (Hemiptera: Cicadellidae). Tissue Cell 2006; 38:257-61. [PMID: 16876837 DOI: 10.1016/j.tice.2006.06.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [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: 04/06/2006] [Revised: 06/03/2006] [Accepted: 06/06/2006] [Indexed: 11/26/2022]
Abstract
An ultrastructural study of the novel symbiont Cardinium sp. was performed with particular attention to the description of the structure and organization of highly elaborated cytoplasmic complexes containing microtubule-like elements (MLC). Three major components were observed. The first was a system of microtubule-like elements (ML) arranged in parallel array extending from the plasma membrane into the cytosol of the bacterium. The second, an fibrous electrondense plaque (FEP), approximately 8 nm thick, located 7.5 nm away from the plasma membrane and parallel to it. The third component, not previously reported, was described for the first time in this paper. This consisted of a set of regularly distributed 8 nm electron-dense structures (ES), with a center-to-center spacing of about 12 nm, adhering to the outer leaflet of the plasma membrane. Often, the ES created a close connection between the plasma membrane and the outer membrane, so that in this area they became straight and stiff. The first and second component of these structures are compared to previously described microtubules and microfilaments.
Collapse
Affiliation(s)
- E Bigliardi
- Dipartimento di Biologia Evolutiva, Università di Siena, via A.Moro 2, 53100 Siena, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Sacchi L, Calvi LE, Kramer LH, Ferroglio E, Grandi G, Clementi E, Corona S. The Intradermal Leishmanin Reaction Induces Antigen-specific Maturation of Canine Dendritic Cells with Up-regulation of MHCII Synthesis and Expression. J Comp Pathol 2006; 135:17-24. [PMID: 16814802 DOI: 10.1016/j.jcpa.2006.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 08/10/2005] [Accepted: 02/21/2006] [Indexed: 11/29/2022]
Abstract
Dendritic cells (DCs) are professional antigen-presenting cells that reside in many tissues, including the skin. This study showed that intradermal injection of leishmanin in Leishmania infantum-infected dogs induced the "up-regulation" of surface MHCII expression, associated with progressive ultrastrucutural changes characteristic of DC maturation, including the formation of multilaminar MHC class II-containing compartments and arrays of tubulo-vesicular structures. These changes were not observed in control dogs from L. infantum non-endemic areas. The results indicated that canine DCs were effector cells in delayed-type hypersensitivity, that the leishmanin reaction was specific for a cell-mediated reaction to L. infantum in infected dogs, and that canine DCs possessed ultrastructural organelles reminiscent of those in activated human DCs.
Collapse
Affiliation(s)
- L Sacchi
- Department of Animal Biology, University of Pavia, Italy
| | | | | | | | | | | | | |
Collapse
|
29
|
Sacchi L, Bigliardi E, Corona S, Beninati T, Lo N, Franceschi A. A symbiont of the tick Ixodes ricinus invades and consumes mitochondria in a mode similar to that of the parasitic bacterium Bdellovibrio bacteriovorus. Tissue Cell 2004; 36:43-53. [PMID: 14729452 DOI: 10.1016/j.tice.2003.08.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [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: 11/24/2022]
Abstract
We have recently performed molecular characterisation of an intracellular alpha-proteobacterium, named IricES1, which resides in the ovarian tissue of female Ixodes ricinus ticks from Italy. A unique characteristic of this bacterium is its ability to invade the mitochondria of the cells in which it resides. Although some ultrastructural studies have been performed on close relatives of this bacterium from I. ricinus in England and Switzerland, a number of questions remain about its movement within ovarian tissues and mitochondria. We have performed the first detailed ultrastructural examination of IricES1 in engorged female adult I. ricinus. Among our findings was that the bacterium enters mitochondria in a similar way to that employed by the 'predatory' bacterium Bdellovibro bacteriovorus, that is, between the inner and outer membranes. It then appears to multiply, with the new 'colony' consuming the mitochondrial matrix. Despite having many of their mitochondria consumed, oocytes appear to develop normally, and the bacteria are likely to be vertically transferred to all eggs.
Collapse
Affiliation(s)
- L Sacchi
- Dipartimento di Biologia Animale, Università di Pavia, Piazza Botta 9, 27100 Pavia, Italy.
| | | | | | | | | | | |
Collapse
|
30
|
Pozio E, Marucci G, Casulli A, Sacchi L, Mukaratirwa S, Foggin CM, La Rosa G. Trichinella papuae and Trichinella zimbabwensis induce infection in experimentally infected varans, caimans, pythons and turtles. Parasitology 2004; 128:333-42. [PMID: 15074882 DOI: 10.1017/s0031182003004542] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [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: 11/07/2022]
Abstract
The discovery of Trichinella zimbabwensis in farm crocodiles of Zimbabwe has opened up a new frontier in the epidemiology of the Trichinella genus. The objective of the present study was to investigate the infectivity of encapsulated species (T. spiralis, T. nativa, T. britovi, T. murrelli and T. nelsoni) and non-encapsulated species (T. pseudospiralis, T. papuae and T. zimbabwensis) in caimans (Caiman crocodilus), varans (Varanus exanthematicus), pythons (Python molurus bivittatus) and turtles (Pelomedusa subrufa) raised at their natural temperature range (26-32 degrees C). Mice and chickens were used as controls. At 6 days post-infection (p.i.), adult worms were detected in the small intestine of reptiles infected with T. papuae and T. zimbabwensis, of chickens infected with T. pseudospiralis and of mice infected with all encapsulated and non-encapsulated species. At 60 days p.i., T. papuae and T. zimbabwensis adult worms were collected from the intestine of varans and caimans and larvae from muscles of the four reptile species, T. pseudospiralis larvae from muscles of chickens, and larvae of all Trichinella species from mouse muscles. The highest reproductive capacity index of both T. papuae and T. zimbabwensis was observed in varans. The results show that T. papuae and T. zimbabwensis are able to complete their entire life-cycle in both poikilothermic and homoiothermic animals.
Collapse
Affiliation(s)
- E Pozio
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 0061 Rome, Italy.
| | | | | | | | | | | | | |
Collapse
|
31
|
Sacchi L. [Ultrastructural basis of interactions between prokaryotes and eukaryotes in different symbiotic models]. Parassitologia 2004; 46:19-24. [PMID: 15305681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
This paper reviews the Author's contribution to the knowledge of the ultrastructural basis of the prokaryote-eukaryote interactions in different models assessed by an ultrastructural approach. In agreement with the hypothesis of the origin of eukaryotic cells, which are chimeras of several prokaryotes with different morpho-functional specializations, symbiosis had major consequence for evolution of life. In Arthropods, one of the most successful lifestyles, the presence of endosymbiotic prokaryotes, plays an important role in their metabolism. In some cases, genome integration has occurred in the endosymbiotic relationships with the host, proving that intracellular symbiosis is not merely a nutritional supplement. Intracellular symbiotic bacteria are also described in nematodes. In particular, the presence of intracellular Wolbachia in filariae, even if its function is not yet completely known, influences positively the reproductive biology and the survival of the host, as proved by antibiotic treatment against this bacterium. The ultrastructural images reported in this review were obtained using different species of cockroaches, termites, ticks and filarial nematodes. The traditional methods of transmission (TEM), scansion (SEM) and immuno electron microscopy were used. In addition, also freeze-fracture and deep-etching techniques were employed. The cockroaches and the primitive termite Mastotermes darwiniensis host symbiotic bacteria in the ovary and in specialized cells (bacteriocytes) of the fat body. These bacteria have the typical cell boundary profile of gram-negative bacteria and are enveloped in a vacuolar membrane produced by the host cell. Molecular sequence data of 16S rDNA of endosymbionts of five species of cockroaches and M. darwiniensis indicate that they are members of the Flavobacteria-bacteroides group and that the infection occurred in an ancestor common to cockroaches and termites probably after the end of the Paleozoic (250 Ma BP). The symbiotic bacteria are transmitted transovarially and, during embryogenesis, they are integrated into the morphogenetic processes. In particular, we were able to demonstrate that the origin of the bacteriocyte should be looked for in the cells of the haemocyte line (embryonic plasmatocytes). The eggs are infected by the bacteria emerging from the bacteriocytes of the ovaric fat body and, at the end of the vitellogenesis, they are actively phagocytized by the egg membrane. In filarial nematodes, intracellular bacteria belonging to the genus Wolbachia have been described: they have evolved an obligatory mutualistic association with their host. In fact, antibiotic treatments lead to the clearance of bacteria and this loss produces a negative impact on reproduction and survival of the filarial host. We evidenced, by TEM, the degenerative events occurring during the embriogenesis of Brugia pahangi and Dirofilaria immitis after tetracycline treatment. The data suggest that the Wolbachia play a direct role in worm metabolism. Finally, a new additional model of the prokaryote-eukaryote interaction has been described: we have recently discovered a new intracellular alpha-proteobacterium, named Iric ES1, which resides in the ovarian tissues of the tick Ixodes ricinus. The intriguing characteristic of this bacterium is its ability to invade and consume the ovaric mitochondria. From an evolutionary perspective, it is interesting to note that Iric ES1 enters mitochondria in a similar way to that employed by the "predatory" bacterium Bdellovibrio bacteriovorus.
Collapse
Affiliation(s)
- L Sacchi
- Dipartimento di Biologia Animale, Università di Pavia
| |
Collapse
|
32
|
Lo N, Beninati T, Sacchi L, Genchi C, Bandi C. [Emerging rickettsioses]. Parassitologia 2004; 46:123-6. [PMID: 15305700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Ticks are known to carry and transmit a number of microbial agents that cause diseases in humans and animals. Among these are members of the order Rickettsiales (alpha-proteobacteria), which include the genera Rickettsia and Ehrlichia. The most common and well-known Rickettsial human disease in Europe is Mediterranean Spotted Fever (MSF), caused by Rickettsia conorii. In recent years, a number of new Rickettsia species have been discovered in Europe, some of which have been shown to be pathogenic to humans. These discoveries have been facilitated by use of sequence-based molecular identification techniques. In Italy, it is generally believed that R. conorii is the only Rickettsia species present, and clinical tests for MSF rely on antigens raised against this bacterium. We are currently undertaking a molecular screening study of Rickettsiales-bacteria in ticks from various regions of Italy, to check for the potential presence of species from this order recently discovered in other parts of Europe. So far, we have identified a number of additional species in ticks collected from northern, central and southern regions. These include the known pathogens R. helvetica and R. slovaca as well as two species which may or may not be of medical relevance: R. monacensis and R. sp. IRS4. As a part of this survey, we have identified a novel alphaproteobacterium from the medically important tick Ixodes ricinus. This bacterium, tentatively named IricES1, has the unusual property of existing within the mitochondria, as well as the cytoplasm, of ovarian cells. To our knowledge, this is the only known example of a bacterium that is able to enter the mitochondria of animals. Our recently published electron microscopic data indicates that the bacterium enters mitochondria between the inner and outer membranes, and then proceeds to consume the inner mitochondrial matrix. We will present further data on this bacterium, including: 1) its phylogenetic position based on various molecular sequences, 2) its localization within the tick based on in situ hybridization; 3) its distribution among tick populations in Europe; 4) preliminary data on attempts at culturing this bacterium in a variety of cell types. Possible interactions between the bacterium and its host will be discussed. Ticks are known to carry and transmit a number of microbial agents that cause diseases in humans and animals. Among these are members of the order Rickettsiales (alpha-proteobacteria), which include the genera Rickettsia and Ehrlichia. The most common and well-known Rickettsial human disease in Europe is Mediterranean Spotted Fever (MSF), caused by Rickettsia conorii. In recent years, a number of new Rickettsia species have been discovered in Europe, some of which have been shown to be pathogenic to humans. These discoveries have been facilitated by use of sequence-based molecular identification techniques. In Italy, it is generally believed that R. conorii is the only Rickettsia species present, and clinical tests for MSF rely on antigens raised against this bacterium. We are currently undertaking a molecular screening study of Rickettsiales-bacteria in ticks from various regions of Italy, to check for the potential presence of species from this order recently discovered in other parts of Europe. So far, we have identified a number of additional species in ticks collected from northern, central and southern regions. These include the known pathogens R. helvetica and R. slovaca as well as two species which may or may not be of medical relevance: R. monacensis and R. sp. IRS4. As a part of this survey, we have identified a novel alphaproteobacterium from the medically important tick Ixodes ricinus. This bacterium, tentatively named IricES1, has the unusual property of existing within the mitochondria, as well as the cytoplasm, of ovarian cells. To our knowledge, this is the only known example of a bacterium that is able to enter the mitochondria of animals. Our recently published electron microscopic data indicates that the bacterium enters mitochondria between the inner and outer membranes, and then proceeds to consume the inner mitochondrial matrix. We will present further data on this bacterium, including: 1) its phylogenetic position based on various molecular sequences, 2) its localization within the tick based on in situ hybridization; 3) its distribution among tick populations in Europe; 4) preliminary data on attempts at culturing this bacterium in a variety of cell types. Possible interactions between the bacterium and its host will be discussed.
Collapse
Affiliation(s)
- N Lo
- Dipartimento di Patologia Animale Veterinaria, Igiene e Sanità Pubblica Veterinaria, Università degli Studi di Milano, Via Celoria, 22, 20133 Milano, Italy
| | | | | | | | | |
Collapse
|
33
|
Sacchi L, Bellazzi R, Larizza C, Magni P, Curk T, Petrovic U, Zupan B. Clustering gene expression data with temporal abstractions. Stud Health Technol Inform 2004; 107:798-802. [PMID: 15360922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
This paper describes a new technique for clustering short time series coming from gene expression data. The technique is based on the labelling of the time series through temporal trend abstractions and a consequent clustering of the series on the basis of their labels. Clustering is performed at three different levels of aggregation of the original time series, so that the results are organized and visualized as a three-levels hierarchical tree. Results on simulated and on yeast data are shown. The technique appears robust and efficient and the results obtained are easy to be interpreted.
Collapse
Affiliation(s)
- L Sacchi
- Dipartimento di Informatica e Sistemica, Università di Pavia, Italy.
| | | | | | | | | | | | | |
Collapse
|
34
|
Sacchi L, Corona S, Kramer L, Calvi L, Casiraghi M, Franceschi A. Ultrastructural evidence of the degenerative events occurring during embryogenesis of the filarial nematode Brugia pahangi after tetracycline treatment. Parassitologia 2003; 45:89-96. [PMID: 15267003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Intracellular bacteria belonging to the genus Wolbachia have been described in filarial nematodes and these microorganisms appear to have evolved an obligatory mutualistic association with their filarial hosts. In fact, antibiotic treatment leads to the clearance of bacteria from worms resulting in a block in embryogenesis and, eventually, death of adult filariae. Currently, the antifilarial action of antibiotic treatment is interpreted as a secondary consequence of the bacteriostatic activity against Wolbachia endosymbionts. Here, we demonstrate by transmission electron microscopy the degenerative events occurring during embryogenesis of Brugia pahangi after tetracycline treatment. After 56 days of treatment the cytoplasm of hypodermal cords was totally void of Wolbachia and numerous vacuoles, residual of cytolitic activity, were observed. In the ovary, the morphology of the oocytes was well conserved 33 days after treatment, but the texture of symbiotic bacteria appeared altered. After 56 days of treatment embryogenesis was dramatically affected and the terminal portion of the ovary appeared totally empty. The authors suggest that the symbiotic bacteria play a direct role in worm metabolism and a long-term bacteriostatic effect may block bacterial activity involved in the active control of cytolysis. As a consequence, the bacteriophorous vacuole is transformed into a digestive vacuole and the whole symbiotic population is disrupted.
Collapse
Affiliation(s)
- L Sacchi
- Dipartimento di Biologia Animale, Università di Pavia, Italy.
| | | | | | | | | | | |
Collapse
|
35
|
Pozio E, Foggin CM, Marucci G, La Rosa G, Sacchi L, Corona S, Rossi P, Mukaratirwa S. Trichinella zimbabwensis n.sp. (Nematoda), a new non-encapsulated species from crocodiles (Crocodylus niloticus) in Zimbabwe also infecting mammals. Int J Parasitol 2002; 32:1787-99. [PMID: 12464425 DOI: 10.1016/s0020-7519(02)00139-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [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: 11/28/2022]
Abstract
Since 1995, Trichinella larvae have been detected in 39.5% of farmed crocodiles (Crocodylus niloticus) in Zimbabwe. Morphological, biological, biochemical and molecular studies carried out on one isolate from a farmed crocodile in 2001 support the conclusion that this parasite belongs to a new species, which has been named Trichinella zimbabwensis n.sp. This species, whose larvae are non-encapsulated in host muscles, infects both reptiles and mammals. The morphology of adults and larvae is similar to that of Trichinella papuae. Adults of T. zimbabwensis cross in both directions with adults of T. papuae (i.e. male of T. zimbabwensis per female of T. papuae and male of T. papuae per female of T. zimbabwensis), producing F1 offspring which produce very few and less viable F2 larvae. Muscle larvae of T. zimbabwensis, like those of T. papuae, do not infect birds. Three allozymes (of a total of 10) are diagnostic between T. zimbabwensis and T. papuae, and five are diagnostic between T. zimbabwensis and Trichinella pseudospiralis, the third non-encapsulated species. The percentage of the pairwise alignment identity between T. zimbabwensis and the other Trichinella species for the cytochrome oxidase subunit I gene, the large subunit ribosomal-DNA (mt-lsrDNA) gene and the expansion segment five, shows that T. zimbabwensis is more similar to the two non-encapsulated species T. papuae (91% for cytochrome oxidase I; 96% for mt-lsrDNA; and 88% for expansion segment five) and T. pseudospiralis (88% for cytochrome oxidase I; 90% for mt-lsrDNA; and 66-73% for expansion segment five) than to any of the encapsulated species (85-86% for cytochrome oxidase I; 88-89% for mt-lsrDNA; and 71-79% for expansion segment five). This is the first non-encapsulated species discovered in Africa. The finding of a new Trichinella species that infects both reptiles and mammals suggests that the origin of Trichinella parasites dates back further than previously believed and can contribute to understanding the phylogeny and the epidemiology of the genus Trichinella.
Collapse
Affiliation(s)
- E Pozio
- Laboratory of Parasitology, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Casiraghi M, McCall JW, Simoncini L, Kramer LH, Sacchi L, Genchi C, Werren JH, Bandi C. Tetracycline treatment and sex-ratio distortion: a role for Wolbachia in the moulting of filarial nematodes? Int J Parasitol 2002; 32:1457-68. [PMID: 12392911 DOI: 10.1016/s0020-7519(02)00158-3] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Filarial nematodes harbour intracellular bacteria of the genus Wolbachia. These bacteria are thought to be beneficial to the host nematode. Indeed, tetracycline treatments reduce the population of Wolbachia in filarial worms and have detrimental effects on the nematode. Even though various antibiotic-curing experiments have been performed on filariae, the actual role of Wolbachia in the biology of these nematodes is not yet clear. To address this issue, we designed a first experiment on a model filaria (Brugia pahangi), maintained in the gerbil (Meriones unguiculatus). In this experiment, timing of tetracycline treatment was set on the basis of the larval stage of the nematode. This first experiment showed that 2 weeks of treatment started after the L(4)-L(5) moult of males, but before the moult of females, led to significant sex-ratio distortion of the nematodes. We thus hypothesised that tetracycline interferes with the moult in B. pahangi. To test this hypothesis, we designed a second experiment in which antibiotic treatments were started (1). before the moult of both sexes, (2). after the moult of males but before the moult of females, or (3). after the moult of both sexes. Treatment 1 determined a reduction of worm recovery with no sex bias. Treatment 2 led to a male-biased sex-ratio. Treatment 3 had no effect on either worm recovery or sex-ratio. These results thus support the hypothesis that tetracycline treatment interferes with the L(4)-L(5) moult of B. pahangi. The nematodes recovered from the treated and control animals were examined for the presence of Wolbachia using both immunohistochemistry and real-time PCR. In general, nematodes from treated animals showed a dramatic reduction in Wolbachia content. In one group, Wolbachia depletion, as observed at the end of the treatment, was followed by a rebound to 'normal' values 160 days later. Prospects for antifilarial therapy using Wolbachia-targeted tetracycline treatments should thus take into account the possibility of Wolbachia rebound.
Collapse
Affiliation(s)
- M Casiraghi
- Dipartimento di Patologia Animale, Università di Milano, Milan, Italy
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
The purpose of the study is to assess whether employees of the Municipal Police Force of a big city exposed to urban pollution are at risk of hepatotoxicity. The usual clinical practice tests like AST, ALT, gamma-GT, AP, conjugated and total bilirubin were carried out, accompanied by a questionnaire designed to identify the possible risk factors and the principal non-professional confounding factors for hepatotoxicity. The study covered 118 male Municipal Police employees performing traffic duties and 118 male blood donors engaged in office work. There were significant differences between exposed and controls with regard to the average AST and ALT values and values above the normal laboratory range; this was also the case for the distribution. The results suggest that there may be the possibility of liver damage among asymptomatic members of the Municipal Police Force and that periodic hepatic screening, with the above-mentioned tests, could be useful. It is presumed that chemical agents present in urban air in big cities may cause damage to the liver, even at exposure levels that fluctuate around the admissible environmental concentrations.
Collapse
Affiliation(s)
- E Tomao
- Center For Aeromedical Evaluation and Occupational Medicine, IML, ITAF, Rome, Italy
| | | | | | | | | |
Collapse
|
38
|
Abstract
Information on the ultrastructural details of fertilization in filarial nematodes are still unavailable. Here we report new data on this process in Dirofilaria immits, the heartworm of dogs and cats. Electron microscopy allowed us to observe oocytes engulfing spermatozoa through an endocytosis-like process. We also observed spermatozoa inside the oocytes which still possessed their plasma membrane and which were clearly enveloped by a further membrane, likely derived from the endocytosis process. At this stage, at the interface between the sperm membrane and the endocytotic membrane (vacuolar space), we observed flocculent material in the proximity of the membranous organelles (MOs) of the sperm. In the proximity of the MOs, we also observed the enlargement of the vacuolar space. Other images showed the dissolution of the sperm membrane, and the release of nuclear masses and organelles in the egg cytoplasm. We did not observe the fusion of lysosomes to the endocytotic vacuoles. In addition, the lysis of the sperm organelles has never been observed inside the vacuoles containing the whole sperm. Thus we suggest that the degradation of the endocytotic and sperm plasma membranes is determined by material released by the MOs. Since we did not observe the entry of sperm into the oocytes by other mechanisms, we also suggest that endocytosis is the normal process used by the spermatozoon to get into the egg cytoplasm in D. immitis. Finally, during our observations of the seminal receptacle we did not observe any structure in the spermatozoa which could be interpreted as an intracellular bacterium. This is consistent with previous results indicating that the bacterium Wolbachia in filarial nematodes is not transmitted through the sperm.
Collapse
Affiliation(s)
- L Sacchi
- Dipartimento di Biologia Animale, Università di Pavia, Italy
| | | | | | | |
Collapse
|
39
|
Simoncini L, Casiraghi M, Bazzocchi C, Sacchi L, Bandi C, Genchi C. Real-time PCR for quantification of the bacterial endosymbionts (Wolbachia) of filarial nematodes. Parassitologia 2001; 43:173-8. [PMID: 12402526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Filarial nematodes harbour intracellular symbiotic bacteria belonging to the genus Wolbachia. Wolbachia is thought to play an important role in the biology of the nematode. Moreover, Wolbachia appears to be involved in the immunopathogenesis of filariasis and in the onset of the side-effects of antifilarial therapy. Investigations in these research areas require reliable methods to quantify Wolbachia both in nematodes and in vertebrate tissues. To this purpose, we designed a quantitative real-time PCR targeted on the ftsZ gene of the Wolbachia of Brugia pahangi, a model filarial species maintained in gerbils. The method was applied to quantify Wolbachia in Brugia pahangi, from animals with or without tetracycline treatment. Our results show that tetracycline treatment leads to dramatic reduction or clearance of Wolbachia from the nematode. Results obtained from different replicates were reproducible and the method appeared very sensitive compared to other PCR protocols for Wolbachia detection. Real-time PCR is thus an appropriate method for investigations on the biological role of Wolbachia and on the implication of these bacteria in the pathogenesis of filariasis. With slight modifications of the primers and probe, the protocol we have developed could be applied in studies of the human pathogen Brugia malayi and on the model filarial species Litomosoides sigmodontis.
Collapse
Affiliation(s)
- L Simoncini
- Dipartimento di Patologia Animale Igiene e Sanità Pubblica Veterinaria, Sezione di Patologia Generale e Parassitologia, Università di Milano, via Celoria 10, 20133 Milano, Italy
| | | | | | | | | | | |
Collapse
|
40
|
Abstract
Microsporidia are amitochondrial eukaryotic obligate intracellular parasites. They are reported to infect every animal group from protists to vertebrates, including humans. Microsporidia are of interest as opportunistic pathogens in humans and for certain characteristics which raise questions about their evolution and phylogenetic position. This review describes the basic biology and invasion mechanisms of microsporidian species infecting humans.
Collapse
Affiliation(s)
- E Bigliardi
- Department of Evolutionary Biology, University of Siena, Via Mattioli 4, 53100, Siena, Italy.
| | | |
Collapse
|
41
|
Abstract
The nurse cell-larva complex of nematodes of the genus Trichinella plays an important role in the survival of the larva in decaying muscles, frequently favouring the transmission of the parasite in extreme environmental conditions. The ultrastructure of the nurse cell-larva complex in muscles from different hosts infected with T. nativa (a walrus and a polar bear), T. spiralis (horses and humans), T. pseudospiralis (a laboratory mouse) and T. papuae (a laboratory mouse) were examined. Analysis with transmission electron microscope showed that the typical nurse cell structure was present in all examined samples, irrespective of the species of larva, of the presence of a collagen capsule, of the age of infection and of the host species, suggesting that there exists a molecular mechanism that in the first stage of larva invasion is similar for encapsulated and non-encapsulated species.
Collapse
Affiliation(s)
- L Sacchi
- Department of Animal Biology, University of Pavia, Pavia, Italy
| | | | | | | |
Collapse
|
42
|
Pozio E, Sacchini D, Sacchi L, Tamburrini A, Alberici F. Failure of mebendazole in the treatment of humans with Trichinella spiralis infection at the stage of encapsulating larvae. Clin Infect Dis 2001; 32:638-42. [PMID: 11181129 DOI: 10.1086/318707] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [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: 03/23/2000] [Revised: 06/12/2000] [Indexed: 11/03/2022] Open
Abstract
Trichinella spiralis larvae infective for laboratory mice were collected from muscle biopsies performed at different times (from 1 day to 16 months) following the end of treatment, indicating the failure of mebendazole to kill Trichinella parasites when they are encapsulating in muscles.
Collapse
Affiliation(s)
- E Pozio
- Laboratory of Parasitology, Istituto Superiore di Sanità, Rome, Italy.
| | | | | | | | | |
Collapse
|
43
|
Bigliardi E, Bernuzzi AM, Corona S, Gatti S, Scaglia M, Sacchi L. In vitro efficacy of nikkomycin Z against the human isolate of the microsporidian species Encephalitozoon hellem. Antimicrob Agents Chemother 2000; 44:3012-6. [PMID: 11036015 PMCID: PMC101595 DOI: 10.1128/aac.44.11.3012-3016.2000] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/20/2022] Open
Abstract
Since 1985 microsporidia have been recognized as a cause of emerging infections in humans, mainly in immunocompromised human immunodeficiency virus-positive subjects. As chitin is a basic component of the microsporidian infective stage, the spore, we evaluated in vitro the susceptibility of a human-derived strain of Encephalitozoon hellem to nikkomycin Z, a peptide-nucleoside antibiotic known as a competitive inhibitor of chitin synthase enzymes. Transmission electron microscopy showed that this drug, at 25 microgram/ml, reduced the number of parasitic foci by about 35% +/- standard deviation after 7 days of culture (P < 0.0001) and induced cell damage of both mature and immature spores and also other sporogonic and merogonic stages. In particular, an irregular outline of the cell shape and an abnormally condensed cytoplasm in meronts and sporonts were documented. Also, the polar tubule and the polaroplast membranes appeared disarrayed in the sporoblast stage. The spore wall showed an enlarged endospore and delaminated exospore. Mature spores had a complete cytoplasmic disorganization and a swollen and delaminated cell wall. No ultrastructural cell damage was observed in uninfected control cultures treated with the drug.
Collapse
Affiliation(s)
- E Bigliardi
- Department of Evolutionary Biology, University of Siena, Pavia, Italy
| | | | | | | | | | | |
Collapse
|
44
|
Columbo G, Levi Setti P, Sacchi L, Patriarca C, Columbo P, Pardi G. A New Method to Assess β3 Integrin in the Window of Implantation as Part of Clinical Standard Evaluation of the Luteal Phase. Fertil Steril 2000. [DOI: 10.1016/s0015-0282(00)01043-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
45
|
Pozio E, Owen IL, La Rosa G, Sacchi L, Rossi P, Corona S. Trichinella papuae n.sp. (Nematoda), a new non-encapsulated species from domestic and sylvatic swine of Papua New Guinea. Int J Parasitol 1999; 29:1825-39. [PMID: 10616929 DOI: 10.1016/s0020-7519(99)00135-6] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [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: 11/17/2022]
Abstract
Encapsulated and non-encapsulated species of the genus Trichinella are widespread in sylvatic animals in almost all zoogeographical regions. In sylvatic animals from Tasmania (Australian region), only the non-encapsulated species Trichinella pseudospiralis has been reported. Between 1988 and 1998, non-encapsulated larvae of Trichinella were detected in five domestic pigs and six wild boars from a remote area of Papua New Guinea. Morphological, biological, and molecular studies carried out on one strain isolated from a wild boar in 1997 suggest that these parasites belong to a new species, which has been named Trichinella papuae n.sp. This species can be identified by the morphology of muscle larvae, which lack a nurse cell in host muscles, and whose total length is one-third greater than that of the other non-encapsulated species, T. pseudospiralis. Adults of T. papuae do not cross with adults of the other species and genotypes. Muscle larvae of T. papuae are unable to infect birds, whereas those of T. pseudospiralis do. The expansion segment V of the large subunit of the ribosomal DNA differs from that of the other species and genotypes. All of these features allow for the easy identification of T. papuae, even in poorly equipped laboratories. The discovery and identification of a second non-encapsulated species in the Australian region strongly supports the existence of two evolutionary lines in the genus Trichinella, which differ in terms of the capacity of larvae to induce a modification of the muscle cell into a nurse cell.
Collapse
Affiliation(s)
- E Pozio
- Laboratory of Parasitology, Istituto Superiore di Sanità, Rome, Italy.
| | | | | | | | | | | |
Collapse
|
46
|
Pozio E, Paterlini F, Pedarra C, Sacchi L, Bugarini R, Goffredo E, Boni P. Predilection sites of Trichinella spiralis larvae in naturally infected horses. J Helminthol 1999; 73:233-7. [PMID: 10526416 DOI: 10.1017/s0022149x99000360] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [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: 11/07/2022]
Abstract
A total of 120 muscle tissues from three horses naturally infected with Trichinella spiralis were examined. The head was the most infected site. In particular, the muscles harbouring the highest number of larvae were: musculus buccinator (12, 411 and 1183 larvae g-1), the tongue (11, 615 and 1749 larvae g-1), m. levator labii maxillaris (17,582 and 1676 larvae g-1), and the masseter (4.9, 289 and 821 larvae g-1). Compared with the diaphragm, the number of larvae per gram was from 3.5 to 6.8 times higher in the tongue, from 3.5 to 6.5 higher in m. levator labii maxillaris, and from 2.5 to 4.6 higher in m. buccinator. Of the examined muscles, the diaphragm had from the 6th to the 15th highest level of infection (3.1, 166 and 256 larvae g-1). Published data from experimentally infected horses confirm these results, suggesting that efforts to detect predilection sites should focus on the head muscles.
Collapse
Affiliation(s)
- E Pozio
- Istituto Superiore di Sanità, Rome, Italy.
| | | | | | | | | | | | | |
Collapse
|
47
|
Bigliardi E, Riparbelli MG, Selmi MG, Bini L, Liberatori S, Pallini V, Bernuzzi A, Gatti S, Scaglia M, Sacchi L. Evidence of actin in the cytoskeleton of microsporidia. J Eukaryot Microbiol 1999; 46:410-5. [PMID: 10532801 DOI: 10.1111/j.1550-7408.1999.tb04621.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 11/30/2022]
Abstract
Using transmission electron microscopy, immuno-electron microscopy, and biochemical techniques such as 2-D electrophoresis and immunoblotting, actin was found in all biological stages of the microsporidia Encephalitozoon hellem and Encephalitozoon cuniculi.
Collapse
Affiliation(s)
- E Bigliardi
- Department of Evolutionary Biology, University, Via Mattioli, Sienna, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Kapel CM, Pozio E, Sacchi L, Prestrud P. Freeze tolerance, morphology, and RAPD-PCR identification of Trichinella nativa in naturally infected arctic foxes. J Parasitol 1999; 85:144-7. [PMID: 10207384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Arctic foxes (Alopex lagopus) were collected from Greenland and Svalbard (N = 319). Twenty-four were infected with Trichinella (7.5%). Molecular analysis (random-amplified polymorphic DNA polymerase chain reaction) confirmed that all animals were infected with Trichinella nativa. Motile larvae were found in muscle tissue from all foxes after carcasses had been frozen for 1 yr at -18 C. Infective larvae were found in 2 foxes after a total of 4 yr storage at -18 C, which is longer than any previous observations. Morphological examination of the cysts showed large nurse cells and significant deposition of collagen and connective tissue. It is suggested that, within the geographical distribution of T. nativa, the more freeze-resistant isolates are found at higher latitudes.
Collapse
Affiliation(s)
- C M Kapel
- Danish Centre for Experimental Parasitology, Royal Veterinary and Agricultural University, Frederiksberg, Denmark
| | | | | | | |
Collapse
|
49
|
Hurst GD, Bandi C, Sacchi L, Cochrane AG, Bertrand D, Karaca I, Majerus ME. Adonia variegata (Coleoptera: Coccinellidae) bears maternally inherited flavobacteria that kill males only. Parasitology 1999; 118 ( Pt 2):125-34. [PMID: 10028525 DOI: 10.1017/s0031182098003655] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.3] [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: 11/07/2022]
Abstract
Inherited bacteria that parasitically distort the pattern of sex allocation of their host, biasing allocation towards female progeny, are found in many arthropods. One such manipulation is male-killing, where male progeny of infected females die during embryogenesis. We here provide evidence for a male-killing bacterium in the coccinellid beetle, Adonia variegata. We then address 3 questions. First, is this male-killing bacterium one that is found in other hosts, or does it represent a new transition to male-killing within the eubacteria? Using the sequence of the 16S rDNA of the bacterium, we found that the male-killing bacterium is a member of the Flavobacteria--Bacteroides group, most closely related to the male-killing bacterium in another ladybird beetle, Coleomegilla maculata. Secondly, is there any evidence that this bacterium affects female host physiology? In a paired test under nutritional stress, we found no evidence for a physiological benefit to infection, and weak evidence of a physiological cost, in terms of reduced fecundity. Thirdly, is there any evidence of host involvement in the transmission of the bacterium to the germ line? We found no evidence of host involvement. Rather, bacteria migrated to the ovariole independently of host cells. We conclude that the bacterium is a parasite, and discuss how 2 different species of ladybird come to be infected with 1 lineage of bacterium, and why case studies of male-killing bacteria have generally found little evidence of any symbiont contribution to host physiological functioning.
Collapse
Affiliation(s)
- G D Hurst
- Department of Biology, University College London, UK.
| | | | | | | | | | | | | |
Collapse
|
50
|
Kapel CMO, Pozio E, Sacchi L, Prestrud P. Freeze Tolerance, Morphology, and RAPD-PCR Identification of Trichinella nativa in Naturally Infected Arctic Foxes. J Parasitol 1999. [DOI: 10.2307/3285722] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|