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Gut D, Trombini M, Kucybała I, Krupa K, Rozynek M, Dellepiane S, Tabor Z, Wojciechowski W. Use of superpixels for improvement of inter-rater and intra-rater reliability during annotation of medical images. Med Image Anal 2024; 94:103141. [PMID: 38489896 DOI: 10.1016/j.media.2024.103141] [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: 09/29/2022] [Revised: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 03/17/2024]
Abstract
In the context of automatic medical image segmentation based on statistical learning, raters' variability of ground truth segmentations in training datasets is a widely recognized issue. Indeed, the reference information is provided by experts but bias due to their knowledge may affect the quality of the ground truth data, thus hindering creation of robust and reliable datasets employed in segmentation, classification or detection tasks. In such a framework, automatic medical image segmentation would significantly benefit from utilizing some form of presegmentation during training data preparation process, which could lower the impact of experts' knowledge and reduce time-consuming labeling efforts. The present manuscript proposes a superpixels-driven procedure for annotating medical images. Three different superpixeling methods with two different number of superpixels were evaluated on three different medical segmentation tasks and compared with manual annotations. Within the superpixels-based annotation procedure medical experts interactively select superpixels of interest, apply manual corrections, when necessary, and then the accuracy of the annotations, the time needed to prepare them, and the number of manual corrections are assessed. In this study, it is proven that the proposed procedure reduces inter- and intra-rater variability leading to more reliable annotations datasets which, in turn, may be beneficial for the development of more robust classification or segmentation models. In addition, the proposed approach reduces time needed to prepare the annotations.
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Affiliation(s)
- Daniel Gut
- Department of Biocybernetics and Biomedical Engineering, AGH University of Krakow, al. Mickiewicza 30, 30-059 Krakow, Poland.
| | - Marco Trombini
- Department of Electric, Electronic, and Telecommunication Engineering and Naval Architecture - DITEN, Università degli Studi di Genova, Via all'Opera Pia 11, 16145 Genoa, Italy
| | - Iwona Kucybała
- Department of Radiology, Jagiellonian University Medical College, ul. Kopernika 19, 31-501 Krakow, Poland
| | - Kamil Krupa
- Department of Radiology, Jagiellonian University Medical College, ul. Kopernika 19, 31-501 Krakow, Poland
| | - Miłosz Rozynek
- Department of Radiology, Jagiellonian University Medical College, ul. Kopernika 19, 31-501 Krakow, Poland
| | - Silvana Dellepiane
- Department of Electric, Electronic, and Telecommunication Engineering and Naval Architecture - DITEN, Università degli Studi di Genova, Via all'Opera Pia 11, 16145 Genoa, Italy
| | - Zbisław Tabor
- Department of Biocybernetics and Biomedical Engineering, AGH University of Krakow, al. Mickiewicza 30, 30-059 Krakow, Poland
| | - Wadim Wojciechowski
- Department of Radiology, Jagiellonian University Medical College, ul. Kopernika 19, 31-501 Krakow, Poland
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Trombini M, Ferraro F, Iaconi G, Vestito L, Bandini F, Mori L, Trompetto C, Dellepiane S. A Study Protocol for Occupational Rehabilitation in Multiple Sclerosis. Sensors (Basel) 2021; 21:s21248436. [PMID: 34960529 PMCID: PMC8707782 DOI: 10.3390/s21248436] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/22/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Abstract
Digital medical solutions can be very helpful in restorative neurology, as they allow the patients to practice their rehabilitation activities remotely. This work discloses ReMoVES, an IoMT system providing telemedicine services, in the context of Multiple Sclerosis rehabilitation, within the frame of the project STORMS. A rehabilitative protocol of exercises can be provided as ReMoVES services and integrated into the Individual Rehabilitation Project as designed by a remote multidimensional medical team. In the present manuscript, the first phase of the study is described, including the definition of the needs to be addressed, the employed technology, the design and the development of the exergames, and the possible practical/professional and academic consequences. The STORMS project has been implemented with the aim to act as a starting point for the development of digital telerehabilitation solutions that support Multiple Sclerosis patients, improving their living conditions. This paper introduces a study protocol and it addresses pre-clinical research needs, where system issues can be studied and better understood how they might be addressed. It also includes tools to favor remote patient monitoring and to support the clinical staff.
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Affiliation(s)
- Marco Trombini
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), Università degli Studi di Genova, Via all’Opera Pia 11a, I-16145 Genoa, Italy; (M.T.); (F.F.); (G.I.)
| | - Federica Ferraro
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), Università degli Studi di Genova, Via all’Opera Pia 11a, I-16145 Genoa, Italy; (M.T.); (F.F.); (G.I.)
| | - Giulia Iaconi
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), Università degli Studi di Genova, Via all’Opera Pia 11a, I-16145 Genoa, Italy; (M.T.); (F.F.); (G.I.)
| | - Lucilla Vestito
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Children’s Sciences (DINOGMI), Università degli Studi di Genova, Largo Paolo Daneo 3, I-16132 Genoa, Italy; (L.V.); (L.M.); (C.T.)
- Ospedale Policlinico San Martino IRCCS, Largo Rosanna Benzi 10, I-16132 Genoa, Italy
| | - Fabio Bandini
- Struttura Complessa di Neurologia-Ospedale Villa Scassi ASL 3, Corso Onofrio Scassi 1, I-16149 Genoa, Italy;
| | - Laura Mori
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Children’s Sciences (DINOGMI), Università degli Studi di Genova, Largo Paolo Daneo 3, I-16132 Genoa, Italy; (L.V.); (L.M.); (C.T.)
- Ospedale Policlinico San Martino IRCCS, Largo Rosanna Benzi 10, I-16132 Genoa, Italy
| | - Carlo Trompetto
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Children’s Sciences (DINOGMI), Università degli Studi di Genova, Largo Paolo Daneo 3, I-16132 Genoa, Italy; (L.V.); (L.M.); (C.T.)
- Ospedale Policlinico San Martino IRCCS, Largo Rosanna Benzi 10, I-16132 Genoa, Italy
| | - Silvana Dellepiane
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), Università degli Studi di Genova, Via all’Opera Pia 11a, I-16145 Genoa, Italy; (M.T.); (F.F.); (G.I.)
- Correspondence: ; Tel.: +39-(0)1-0335-2754
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Trombini M, Ferraro F, Nardelli A, Vestito L, Schenone G, Mori L, Trompetto C, Dellepiane S. On the performance assessment during the practice of an exergame for cerebellar ataxia patients. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:5747-5751. [PMID: 34892425 DOI: 10.1109/embc46164.2021.9630289] [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: 06/14/2023]
Abstract
Cerebellar ataxias are a large family of movement disorders that generally follow a stroke. The clinical picture is very complicated and normal activities become difficult for ataxic patients. For instance, dynamic ataxia involves both walk and upper-limbs movement, thus affecting the possibility to fulfill daily life tasks. Rehabilitation treatments and strategies for cerebellar ataxia are nowadays controversial, since different opinions on the several approaches are spread among the clinical community. The purpose of the present work is not to shed some light on such disagreements. Indeed, here a solution for delivering rehabilitation activities in the form of videogame is presented. Data related to patient's performance are collected and analyzed in order to provide the clinical staff with objective indicators that properly describe the activity. Such information can also be used to discuss the effectiveness and the incidence of some strategy adopted for fulfilling some task. The experimental phase is conducted on two case-studies with regards to the upper-limb rehabilitation. The adoption of the strategy of weighting the limb when performing the movement is discussed. The indicators computed in both sessions with and without strategy are compared, also referring to the practice of some healthy subjects. The present work introduces the preliminary phase of a wider study and foretells its future development conducted on a larger population.
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Abstract
Cultural heritage preservation is a crucial topic for our society. When dealing with fine art, color is a primary feature that encompasses much information related to the artwork’s conservation status and to the pigments’ composition. As an alternative to more sophisticated devices, the analysis and identification of color pigments may be addressed via a digital camera, i.e., a non-invasive, inexpensive, and portable tool for studying large surfaces. In the present study, we propose a new supervised approach to camera characterization based on clustered data in order to address the homoscedasticity of the acquired data. The experimental phase is conducted on a real pictorial dataset, where pigments are grouped according to their chromatic or chemical properties. The results show that such a procedure leads to better characterization with respect to state-of-the-art methods. In addition, the present study introduces a method to deal with organic pigments in a quantitative visual approach.
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Affiliation(s)
- Marco Trombini
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture, Università degli Studi di Genova, Via All’Opera Pia 11A, 16145 Genoa, Italy; (M.T.); (F.F.)
| | - Federica Ferraro
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture, Università degli Studi di Genova, Via All’Opera Pia 11A, 16145 Genoa, Italy; (M.T.); (F.F.)
| | - Emanuela Manfredi
- Department of Chemistry and Industrial Chemistry, Università degli Studi di Genova, Via Dodecaneso 31, 16146 Genoa, Italy; (E.M.); (G.P.)
| | - Giovanni Petrillo
- Department of Chemistry and Industrial Chemistry, Università degli Studi di Genova, Via Dodecaneso 31, 16146 Genoa, Italy; (E.M.); (G.P.)
| | - Silvana Dellepiane
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture, Università degli Studi di Genova, Via All’Opera Pia 11A, 16145 Genoa, Italy; (M.T.); (F.F.)
- Correspondence: ; Tel.: +39-348-7920633
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Borro P, Ziola S, Pasta A, Trombini M, Labanca S, Marenco S, Solarna D, Pisciotta L, Baldissarro I, Picciotto A, Dellepiane S. Hepatic Elastometry and Glissonian Line in the Assessment of Liver Fibrosis. Ultrasound Med Biol 2021; 47:947-959. [PMID: 33451815 DOI: 10.1016/j.ultrasmedbio.2020.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
The aim of this study was to identify a method for staging hepatic fibrosis using a non-invasive, rapid and inexpensive technique based on ultrasound morphologic hepatic features. A total of 215 patients with different liver diseases underwent B-mode (2-D brightness mode) ultrasonography, vibration-controlled transient elastography, 2-D shear wave elastography and measurement of the controlled attenuation parameter with transient elastography. B-Mode images of the anterior margin of the left lobe were obtained and processed with automatic Genoa Line Quantification (GLQ) software based on a neural network for staging liver fibrosis. The accuracy of GLQ was 90.6% during model training and 78.9% in 38 different patients with concordant elastometric measures. Receiver operating characteristic curve analysis of GLQ performance using vibration-controlled transient elastography as a reference yielded areas under the curves of 0.851 for F ≥ F1, 0.793 for F ≥ F2, 0.784 for F ≥ F3 and 0.789 for F ≥ F4. GLQ has the potential to be a rapid, easy-to-perform and tolerable method in the staging of liver fibrosis.
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Affiliation(s)
- Paolo Borro
- Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
| | - Sebastiano Ziola
- Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Andrea Pasta
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Marco Trombini
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), University of Genoa, Genoa, Italy
| | - Sara Labanca
- Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Simona Marenco
- Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - David Solarna
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), University of Genoa, Genoa, Italy
| | - Livia Pisciotta
- Department of Internal Medicine, University of Genoa, Genoa, Italy; Dietetics and Clinical Nutrition Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Antonino Picciotto
- Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Silvana Dellepiane
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), University of Genoa, Genoa, Italy
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Vestito L, Trombini M, Mori L, Dellepiane S, Trompetto C, Morando M, Bandini F. Improved visuospatial neglect after tDCS and computer-assisted cognitive training in Posterior Cortical Atrophy: a single-case study. Neurocase 2021; 27:57-63. [PMID: 33332244 DOI: 10.1080/13554794.2020.1862242] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Visuospatial neglect (VN) frequently occurs in Posterior Cortical Atrophy (PCA) and requires specific rehabilitation. In this single-case study, we investigated the efficacy of a computer-assisted cognitive training (CCT) alone or coupled with multiple sessions of anodal transcranial direct-current stimulation (A-tDCS) over the right posterior parietal cortex in improving left VN symptoms in a patient with PCA. The digital ReMoVES platform was used for both VN assessment and training. We found a significant improvement after CCT combined with A-tDCS within the limits of a single-case, our results suggest, for the first time, the usefulness of this combined approach in a neurodegenerative disorder.
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Affiliation(s)
| | - Marco Trombini
- Department of Naval, Electric, Electronic and Telecommunications Engineering (DITEN), University of Genoa, Genoa, Italy
| | - Laura Mori
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Silvana Dellepiane
- Department of Naval, Electric, Electronic and Telecommunications Engineering (DITEN), University of Genoa, Genoa, Italy
| | - Carlo Trompetto
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Matteo Morando
- Department of Naval, Electric, Electronic and Telecommunications Engineering (DITEN), University of Genoa, Genoa, Italy
| | - Fabio Bandini
- Department of Neurology, San Paolo Hospital, Savona, Italy
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Trombini M, Vestito L, Morando M, Mori L, Trompetto C, Bandini F, Dellepiane S. Unilateral spatial neglect rehabilitation supported by a digital solution: two case-studies. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:3670-3675. [PMID: 33018797 DOI: 10.1109/embc44109.2020.9175834] [Citation(s) in RCA: 3] [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: 11/08/2022]
Abstract
Digital solutions for unilateral spatial neglect (USN) assessment and treatment are nowadays of great interest, because of both the possibility of combining them with other rehabilitation practices, and the easy-to-understand data and indicators they collect. The ReMoVES platform, developed in DITEN laboratories, is conceived in the Assistive Technologies framework and provides motor and cognitive exergames and activities to be performed in conjunction with traditional rehabilitation. In this work, two case-studies, related to the USN rehabilitation, are presented. The combination of cognitive therapy, delivered by the ReMoVES platform, and transcranial direct-current stimulation (tDCS) technique was used as rehabilitation treatment for both the patients. Data collected at the beginning or at the end of the rehabilitation process, or also during the treatment sessions, are shown and discussed in this paper. This work is a preliminary part of a wider one, that will be conducted involving many different rehabilitation centers, aimed at proving the validity of such an approach to USN treatments.
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Stoppe G, Trombini M, Maeck L. Ambulatory Care for Dementia in Switzerland: Results of a Nationwide Survey. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30106-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rabovsky K, Trombini M, Allemann D, Stoppe G. Efficacy of bifocal diagnosis-independent group psychoeducation in severe psychiatric disorders: results from a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2012; 262:431-40. [PMID: 22290638 DOI: 10.1007/s00406-012-0291-1] [Citation(s) in RCA: 15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 01/10/2012] [Indexed: 12/12/2022]
Abstract
Despite evidence for its efficacy, diagnosis-specific psychoeducation is not routinely applied. This exploratory randomized controlled trial analyses the efficacy of an easily implementable bifocal diagnosis-mixed group psychoeducation in the treatment of severe psychiatric disorders regarding readmission, compliance and clinical variables, for example global functioning. Inpatients of the Psychiatric Hospital of the University of Basel (N = 82) were randomly assigned to a diagnosis-mixed psychoeducational (PE) or a non-specific intervention control group. Relatives were invited to join corresponding family groups. Results at baseline, 3- and 12-month follow-ups are presented. Better compliance after 3 months and a lower suicide rate were significant in favour of PE. For most other outcome variables, no significant differences, however advantages, in PE were found. In summary, it can be concluded that diagnosis-mixed group psychoeducation is effective in the treatment of severe psychiatric disorders. The effects can be classified as induced by distinctive psychoeducational elements. Findings similar to those on psychosis-specific programmes justify clinical application and further investigation.
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Affiliation(s)
- K Rabovsky
- Psychiatric Hospital of the University of Basel, Switzerland.
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Trombini M, Hulshof HJ, Graiani G, Carnevali L, Meerlo P, Quaini F, Sgoifo A. Early maternal separation has mild effects on cardiac autonomic balance and heart structure in adult male rats. Stress 2012; 15:457-70. [PMID: 22085295 DOI: 10.3109/10253890.2011.639414] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Early life adverse experiences have long-term physiologic and behavioral effects and enhance stress sensitivity. This study examined the effects of maternal separation (MS) on cardiac stress responsivity and structure in adulthood. Male Wistar rats were separated from the dams for 3 h per day from postnatal days 2 through 15. When exposed to 5-day intermittent restraint stress (IRS) as adults, MS, and control rats showed similar acute modifications of cardiac sympathovagal balance, quantified via heart rate variability analysis. In addition, MS had no effect on cardiac pacemaker intrinsic activity (as revealed by autonomic blockade with scopolamine and atenolol) and did not affect the circadian rhythmicity of heart rate, neither before nor after IRS. However, MS differed from control rats in cardiac parasympathetic drive following IRS, which was heightened in the latter but remained unchanged in the former, both during the light and dark phases of the daily rhythm. The evaluation of adult cardiac structure indicated that stress experienced during a crucial developmental period induced only modest changes, involving cardiomyocyte hypertrophy, increased density of vascular structures, and myocardial fibrosis. The mildness of these functional-structural effects questions the validity of MS as a model for early stress-induced cardiac disease in humans.
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Affiliation(s)
- M Trombini
- Department of Evolutionary and Functional Biology, University of Parma, Parma, Italy
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Carnevali L, Sgoifo A, Trombini M, Landgraf R, Neumann I, Nalivaiko E. Respiratory pattern reflects state and trait anxiety in rats. Auton Neurosci 2011. [DOI: 10.1016/j.autneu.2011.05.056] [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: 10/18/2022]
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Marozzi F, Codini G, Trombini M, Zoja R, Caccavo D, Gilardi S, De Micheli M, Salvioni P, Ferraguti P, Zanni M. [Acute narcotic addiction deaths in Milan in the years 1985 and 1988: a comparison of diverse trends of the phenomenon]. Ann Ig 1991; 3:359-67. [PMID: 1726628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- F Marozzi
- Ist. di Medicina Legale delle Assicurazioni, Università di Milano
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Lazzarin A, Galli M, Introna M, Negri C, Mantovani A, Mella L, Ferrante P, Parravicini C, Trombini M, Aiuti F. Outbreak of persistent, unexplained, generalized lymphadenopathy with immunological abnormalities in drug addicts in Milan. Infection 1984; 12:372-6. [PMID: 6097548 DOI: 10.1007/bf01645217] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Persistent unexplained lymphadenopathy (LAS) with intermittent fever, weight loss, night sweats and malaise was observed from March to October 1983 in 16 of 133 intravenous drug addicts who had been followed for at least two years in a Center for Drug Addicts Assistance in Milan, Italy. All the subjects lived in a restricted suburban area and indulged in frequent toxicomanic practices and mutual sexual intercourse. The subjects showed immunological alterations such as lymphopenia (50%), decreased T helper/T suppressor ratio (93%), both these abnormalities (43%), decreased T helper cells (75%), increased T suppressor cytotoxic cells (81%), decreased natural killer (NK) activity (77%), anergy (50%) or hypoergy (43%) to recall skin testing and elevated levels of IgG (87%). Anti-HTLV III antibodies were found in 14 of 16 (87%) patients with LAS and in 3 of 11 (27%) symptom-free drug addicts belonging to the same group. It will be important to assess in the future whether this clinical and immunological picture results in acquired immunodeficiency syndrome in an area so far untouched by this disease.
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Lazzarin A, Mella L, Trombini M, Uberti-Foppa C, Franzetti F, Mazzoni G, Galli M. Immunological status in heroin addicts: effects of methadone maintenance treatment. Drug Alcohol Depend 1984; 13:117-23. [PMID: 6609805 DOI: 10.1016/0376-8716(84)90051-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In opiate addicts specific and unspecific immune responses were examined, before and after methadone treatment. Anomalous immune responses were characterized by compromised cellular immunity (functional deficits of polymorphonuclear leukocytes and T-lymphocytes) in association with efficient production of antibodies. After methadone treatment an elevation of leukocyte functions was noted. The presence of elevated titres of circulating immune complexes observed in all the patients tested could bring about a functional exhaustion of neutrophils. The defects of cellular immunity can be considered important risk factors in the pathogenesis of infectious diseases in addicts.
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