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Research paper thumbnail of Klebsiella pneumoniae antibiotic resistance identified by atomic force microscopy

Journal of biosciences, 2017

In the last decade the detection of the resistance of bacteria to antibiotics treatment, develope... more In the last decade the detection of the resistance of bacteria to antibiotics treatment, developed by different kind of bacteria, is becoming a huge problem. We hereby present a different approach to the current problem of detection of bacteria resistance to antibiotics. Our aims were to use the atomic force microscopy (AFM) to investigate bacteria morphological changes in response to antibiotics treatment and explore the possibility of reducing the time required to obtain information on their resistance. In particular, we studied Klebsiella pneumoniae bacteria provided by the Lavagna Hospital ASL4 Liguria (Italy), where there are cases linked with antibiotics resistance of the Klebsiella pneumoniae. By comparing AFM images of bacteria strains treated with different antibiotics is possible to identify unambiguously the Klebsiella pneumoniae strains resistant to antibiotics. In fact, the analysis of the AFM images of the antibiotic-sensitive bacteria shows clearly the presence of mor...

Research paper thumbnail of Ventricular fibrillation and long-QT syndrome due to panhypopituitarism

Journal of Cardiovascular Medicine

Research paper thumbnail of Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT). Italian Study on Complications of Oral Anticoagulant Therapy

Lancet, 1996

Background Bleeding is the most serious complication of the use of oral anticoagulation in the pr... more Background Bleeding is the most serious complication of the use of oral anticoagulation in the prevention and treatment of thromoboembolic complications. We studied the frequency of bleeding complications in outpatients treated routinely in anticoagulation clinics.

Research paper thumbnail of colorectal cancer screening in LHU4 chiavese italy

Journal of preventive medicine and hygiene

Research paper thumbnail of articolo MALNUTRIZIONE CLINICAL CHEMISTRY

Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to ho... more Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 76.8%) and a good sensitivity/specificity profile (83.1%/76.7%) compared with SGA and PINI. Conclusions: We conclude that PAB could represent a feasible and reliable tool in the evaluation of malnutrition, especially in settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.

Research paper thumbnail of Performance evaluation of the ADVIA 2120 hematology analyzer: an international multicenter clinical trial

Laboratory hematology : official publication of the International Society for Laboratory Hematology, 2005

Automated cell counters are widely used in modern clinical laboratories to provide reliable, fast... more Automated cell counters are widely used in modern clinical laboratories to provide reliable, fast, and cost-effective complete blood counts (CBCs), white blood cell differentials, and reticulocyte measurements. In addition, some advanced instruments provide novel parameters, such as the hemoglobin content of reticulocytes or the percentage of hypochromic cells, and are capable of analysis of a variety of body fluids. Bayer recently introduced the ADVIA 2120 system as an automation-ready cell counter for mid- to high-volume testing in the clinical laboratory. This instrument, which builds on the established technology of the ADVIA 120 system, operates with a cyanide-free method for hemoglobin measurement, has a new user interface, and can routinely analyze biological fluid samples in addition to blood. We used 749 samples from 6 worldwide trial sites to evaluate the clinical performance of this new device. Accuracy of the ADVIA 2120 system versus its predecessor model, the ADVIA 120 ...

Research paper thumbnail of Thrombotic events during oral anticoagulant treatment: results of the inception-cohort, prospective, collaborative ISCOAT study: ISCOAT study group (Italian Study on Complications of Oral Anticoagulant Therapy)

Thrombosis and haemostasis, 1997

The paper reports on rate and type of thrombotic events occurring during the observational, prosp... more The paper reports on rate and type of thrombotic events occurring during the observational, prospective, inception-cohort, multicenter ISCOAT study. 2,745 unselected, daily practice patients, consecutively referring to 34 Italian anticoagulation clinics to monitor the oral anticoagulant treatment, were included in the study from beginning of their first anticoagulant course. During a total follow-up of 2,011 patient-years of treatment 70 thrombotic events (3.5 per 100 patient years) were recorded in 67 patients: 20 fatal (1%), 39 major (1.9%) and 11 minor (0.6%). 34/70 events occurred within the first 90 days of treatment (relative risk - at multivariate analysis - of < or =90 days vs. >90 = 20.6, C.I. 12.7-33.5; p <0.0001). The risk was higher in patients aged > or =70 y (1.62, C.I. 1.0-2.61; p <0.05), and when indication for anticoagulant treatment was peripheral/cerebral arterial disease (1.84, C.I. 1.01-3.36; p <0.05). The frequency of thrombotic events was 17....

Research paper thumbnail of Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT)

The Lancet, 1996

Background Bleeding is the most serious complication of the use of oral anticoagulation in the pr... more Background Bleeding is the most serious complication of the use of oral anticoagulation in the prevention and treatment of thromoboembolic complications. We studied the frequency of bleeding complications in outpatients treated routinely in anticoagulation clinics.

Research paper thumbnail of Seriate prealbumin and C-reactive protein measurements in monitoring nutritional intervention in hospitalized patients: a prospective observational study

Mediterranean Journal of Nutrition and Metabolism, 2011

Protein-energy malnutrition (PEM) in hospitalized patients is associated with poor outcomes. Prea... more Protein-energy malnutrition (PEM) in hospitalized patients is associated with poor outcomes. Prealbumin (PAB) has been shown to be a potentially useful tool in PEM assessment. PAB plasma concentrations are closely related to nutritional state and nutritional intervention. However, PAB is also inversely correlated to C-reactive protein (CRP), making difficult the interpretation of PAB changes during tratment of severely ill patients with inflammation and/or infection. Methods: To assess the confounding role of CRP we investigated the role of two seriate measures of PAB and CRP in monitoring the response to nutritional intervention in 83 hospitalized patients enrolled in a nutritional care program (group 1). Data were also collected from 60 patients with low PAB not enrolled in any nutritional program (group 2). Results: When nutritional needs were not satisfied (nutritional intake/needs ratio \75%) we found no PAB increase, whereas there was a significant PAB increase in patients with adequate intake (mean delta-PAB 4.2 mg/dL).

Research paper thumbnail of Syncope without prodromes in patients with normal heart and normal electrocardiogram: a distinct entity

Journal of the American College of Cardiology, 2013

This study sought to investigate the clinical and laboratory findings of patients affected by sud... more This study sought to investigate the clinical and laboratory findings of patients affected by sudden-onset syncope without prodromes who had a normal heart and normal electrocardiogram.

Research paper thumbnail of Prealbumin Serum Concentrations as a Useful Tool in the Assessment of Malnutrition in Hospitalized Patients

Clinical Chemistry, 2006

Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to ho... more Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showe...

Research paper thumbnail of A positive response to head-up tilt testing predicts syncopal recurrence in carotid sinus syndrome patients with permanent pacemakers

The American Journal of Cardiology, 1995

In conclusion, most of the carotid sinus syndrome patients who have syncopal recurrence despite p... more In conclusion, most of the carotid sinus syndrome patients who have syncopal recurrence despite pacing therapy have a positive response to head-up tilt testing, which suggests the presence of a more complex neurogenic disease.

Research paper thumbnail of Klebsiella pneumoniae antibiotic resistance identified by atomic force microscopy

Journal of biosciences, 2017

In the last decade the detection of the resistance of bacteria to antibiotics treatment, develope... more In the last decade the detection of the resistance of bacteria to antibiotics treatment, developed by different kind of bacteria, is becoming a huge problem. We hereby present a different approach to the current problem of detection of bacteria resistance to antibiotics. Our aims were to use the atomic force microscopy (AFM) to investigate bacteria morphological changes in response to antibiotics treatment and explore the possibility of reducing the time required to obtain information on their resistance. In particular, we studied Klebsiella pneumoniae bacteria provided by the Lavagna Hospital ASL4 Liguria (Italy), where there are cases linked with antibiotics resistance of the Klebsiella pneumoniae. By comparing AFM images of bacteria strains treated with different antibiotics is possible to identify unambiguously the Klebsiella pneumoniae strains resistant to antibiotics. In fact, the analysis of the AFM images of the antibiotic-sensitive bacteria shows clearly the presence of mor...

Research paper thumbnail of Ventricular fibrillation and long-QT syndrome due to panhypopituitarism

Journal of Cardiovascular Medicine

Research paper thumbnail of Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT). Italian Study on Complications of Oral Anticoagulant Therapy

Lancet, 1996

Background Bleeding is the most serious complication of the use of oral anticoagulation in the pr... more Background Bleeding is the most serious complication of the use of oral anticoagulation in the prevention and treatment of thromoboembolic complications. We studied the frequency of bleeding complications in outpatients treated routinely in anticoagulation clinics.

Research paper thumbnail of colorectal cancer screening in LHU4 chiavese italy

Journal of preventive medicine and hygiene

Research paper thumbnail of articolo MALNUTRIZIONE CLINICAL CHEMISTRY

Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to ho... more Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 76.8%) and a good sensitivity/specificity profile (83.1%/76.7%) compared with SGA and PINI. Conclusions: We conclude that PAB could represent a feasible and reliable tool in the evaluation of malnutrition, especially in settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.

Research paper thumbnail of Performance evaluation of the ADVIA 2120 hematology analyzer: an international multicenter clinical trial

Laboratory hematology : official publication of the International Society for Laboratory Hematology, 2005

Automated cell counters are widely used in modern clinical laboratories to provide reliable, fast... more Automated cell counters are widely used in modern clinical laboratories to provide reliable, fast, and cost-effective complete blood counts (CBCs), white blood cell differentials, and reticulocyte measurements. In addition, some advanced instruments provide novel parameters, such as the hemoglobin content of reticulocytes or the percentage of hypochromic cells, and are capable of analysis of a variety of body fluids. Bayer recently introduced the ADVIA 2120 system as an automation-ready cell counter for mid- to high-volume testing in the clinical laboratory. This instrument, which builds on the established technology of the ADVIA 120 system, operates with a cyanide-free method for hemoglobin measurement, has a new user interface, and can routinely analyze biological fluid samples in addition to blood. We used 749 samples from 6 worldwide trial sites to evaluate the clinical performance of this new device. Accuracy of the ADVIA 2120 system versus its predecessor model, the ADVIA 120 ...

Research paper thumbnail of Thrombotic events during oral anticoagulant treatment: results of the inception-cohort, prospective, collaborative ISCOAT study: ISCOAT study group (Italian Study on Complications of Oral Anticoagulant Therapy)

Thrombosis and haemostasis, 1997

The paper reports on rate and type of thrombotic events occurring during the observational, prosp... more The paper reports on rate and type of thrombotic events occurring during the observational, prospective, inception-cohort, multicenter ISCOAT study. 2,745 unselected, daily practice patients, consecutively referring to 34 Italian anticoagulation clinics to monitor the oral anticoagulant treatment, were included in the study from beginning of their first anticoagulant course. During a total follow-up of 2,011 patient-years of treatment 70 thrombotic events (3.5 per 100 patient years) were recorded in 67 patients: 20 fatal (1%), 39 major (1.9%) and 11 minor (0.6%). 34/70 events occurred within the first 90 days of treatment (relative risk - at multivariate analysis - of < or =90 days vs. >90 = 20.6, C.I. 12.7-33.5; p <0.0001). The risk was higher in patients aged > or =70 y (1.62, C.I. 1.0-2.61; p <0.05), and when indication for anticoagulant treatment was peripheral/cerebral arterial disease (1.84, C.I. 1.01-3.36; p <0.05). The frequency of thrombotic events was 17....

Research paper thumbnail of Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT)

The Lancet, 1996

Background Bleeding is the most serious complication of the use of oral anticoagulation in the pr... more Background Bleeding is the most serious complication of the use of oral anticoagulation in the prevention and treatment of thromoboembolic complications. We studied the frequency of bleeding complications in outpatients treated routinely in anticoagulation clinics.

Research paper thumbnail of Seriate prealbumin and C-reactive protein measurements in monitoring nutritional intervention in hospitalized patients: a prospective observational study

Mediterranean Journal of Nutrition and Metabolism, 2011

Protein-energy malnutrition (PEM) in hospitalized patients is associated with poor outcomes. Prea... more Protein-energy malnutrition (PEM) in hospitalized patients is associated with poor outcomes. Prealbumin (PAB) has been shown to be a potentially useful tool in PEM assessment. PAB plasma concentrations are closely related to nutritional state and nutritional intervention. However, PAB is also inversely correlated to C-reactive protein (CRP), making difficult the interpretation of PAB changes during tratment of severely ill patients with inflammation and/or infection. Methods: To assess the confounding role of CRP we investigated the role of two seriate measures of PAB and CRP in monitoring the response to nutritional intervention in 83 hospitalized patients enrolled in a nutritional care program (group 1). Data were also collected from 60 patients with low PAB not enrolled in any nutritional program (group 2). Results: When nutritional needs were not satisfied (nutritional intake/needs ratio \75%) we found no PAB increase, whereas there was a significant PAB increase in patients with adequate intake (mean delta-PAB 4.2 mg/dL).

Research paper thumbnail of Syncope without prodromes in patients with normal heart and normal electrocardiogram: a distinct entity

Journal of the American College of Cardiology, 2013

This study sought to investigate the clinical and laboratory findings of patients affected by sud... more This study sought to investigate the clinical and laboratory findings of patients affected by sudden-onset syncope without prodromes who had a normal heart and normal electrocardiogram.

Research paper thumbnail of Prealbumin Serum Concentrations as a Useful Tool in the Assessment of Malnutrition in Hospitalized Patients

Clinical Chemistry, 2006

Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to ho... more Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showe...

Research paper thumbnail of A positive response to head-up tilt testing predicts syncopal recurrence in carotid sinus syndrome patients with permanent pacemakers

The American Journal of Cardiology, 1995

In conclusion, most of the carotid sinus syndrome patients who have syncopal recurrence despite p... more In conclusion, most of the carotid sinus syndrome patients who have syncopal recurrence despite pacing therapy have a positive response to head-up tilt testing, which suggests the presence of a more complex neurogenic disease.