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PAOLA BORELLA
SENIOR PROFESSOR
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze sede ex-Sc. Biomediche
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Pubblicazioni
2023
- Implementation of the PANDA mHealth system for providing a positive pregnancy experience in Tanzania
[Abstract in Rivista]
Campani, Susanna; Paduano, Stefania; Lilungulu, Athanase; Masoi, Theresia; Bargellini, Annalisa; Stornelli, Federica; Stancanelli, Giovanna; Rweyemamu, Maria; Incerti, Federica; Borsari, Lucia; Benski, Anne; Ernest, Alex; Mwampagatwa, Ipyana; Borella, Paola
abstract
2023
- Pre-post study on the microbiome profile of a water network treated with hydrogen peroxide in an italian hospital
[Abstract in Rivista]
Paduano, Stefania; Marchesi, Isabella; Valeriani, Federica; Carluccio, Eugenia; Gianfranceschi, Gianluca; Frezza, Giuseppina; Turchi, Sara; Leo, Carlo; Spica, Vincenzo; Maiorano, Osvaldo; Borella, Paola; Bargellini, Annalisa
abstract
2022
- Use of a mHealth System to Improve Antenatal Care in Low and Lower-Middle Income Countries: Report on Patients and Healthcare Workers' Acceptability in Tanzania
[Articolo su rivista]
Paduano, Stefania; Incerti, Federica; Borsari, Lucia; Benski, Anne Caroline; Ernest, Alex; Mwampagatwa, Ipyana; Lilungulu, Athanase; Masoi, Theresia; Bargellini, Annalisa; Stornelli, Federica; Stancanelli, Giovanna; Borella, Paola; Rweyemamu, Maria Angelica
abstract
Antenatal care (ANC) is considered a cornerstone of reproductive health programmes, but many women face difficulties in accessing these services, particularly in some sub-Saharan African countries, such as Tanzania. This study aimed to test ANC visit acceptability using mHealth system PANDA (Pregnancy And Newborn Diagnostic Assessment) in the Mufindi district (Tanzania). We investigated the ANC visit acceptability of pregnant women and healthcare workers (HCWs) in an intervention area using the PANDA system compared with a control area. An ad hoc questionnaire was administered to pregnant women in an implementation area (n = 52) and in a control area (n = 46). In the implementation area, group interviews with 50 pregnant women were conducted and five HCWs evaluated ANC visits through a questionnaire. The implementation group was significantly more satisfied with the ANC visit compared with the control group. All the 52 women and the HCWs declared that PANDA icons were useful in understanding and remembering the provided information and the PANDA app was able to improve the ANC quality and to positively influence the relationship of HCWs and pregnant women. HCWs reported that the PANDA app was "easy-to-use" and "able to improve the adherence to ANC WHO recommendations". In underserved areas, many pregnant women could benefit from the PANDA system increasing their access to high-quality ANC and overcoming language and/or literacy barriers.
2021
- Anti-SARS-CoV-2 antibodies frequency in non-Health Care Workers in a highly industrialized province of northern Italy
[Relazione in Atti di Convegno]
Modenese, Alberto; Mazzoli, Tommaso; Berselli, Nausicaa; Ferrari, Davide; Bargellini, Annalisa; Borella, Paola; Filippini, Tommaso; Marchesi, Isabella; Paduano, Stefania; Vinceti, Marco; Gobba, Fabriziomaria
abstract
2021
- Frequency of anti-sars-cov-2 antibodies in various occupational sectors in an industrialized area of northern italy from may to october 2020
[Articolo su rivista]
Modenese, A.; Mazzoli, T.; Berselli, N.; Ferrari, D.; Bargellini, A.; Borella, P.; Filippini, T.; Marchesi, I.; Paduano, S.; Vinceti, M.; Gobba, F.
abstract
The results of a voluntary screening campaign for the presence of anti-SARS-CoV-2 serum antibodies are presented, performed on workers in the highly industrialized province of Modena in northern Italy in the period 18 May–5 October 2020. The employment activities of the subjects that tested positive for anti-SARS-CoV-2 IgM and/or IgG antibodies were determined and classified using the International Standard Industrial Classification of All Economic Activities (ISIC). The distribution across different sectors was compared to the proportion of workers employed in the same sectors in the province of Modena as a whole. Workers with anti-SARS-CoV-2 serum antibodies were mainly employed in manufacturing (60%), trade (12%), transportation (9%), scientific and technical activities (5%), and arts, entertainment and recreation activities (4.5%). Within the manufacturing sector, a cluster of workers with positive serological tests was observed in the meat processing sector, confirming recent data showing a possible increased risk of SARS-CoV-2 infection in these workers.
2021
- In vitro virucidal efficacy of a dry steam disinfection system against Human Coronavirus, Human Influenza Virus, and Echovirus
[Articolo su rivista]
Marchesi, Isabella; Sala, Arianna; Frezza, Giuseppina; Paduano, Stefania; Turchi, Sara; Bargellini, Annalisa; Borella, Paola; Cermelli, Claudio
abstract
This in vitro study was aimed to assess the efficacy of dry steam in inactivating Human Coronavirus OC43 (HCoV-OC43) as surrogate of SARS-CoV-2, Human Influenza Virus A/H1N1/
WSN/33 and Echovirus 7 on stainless steel, polypropylene, and cotton. The virus models were chosen on the basis of their transmission route and environmental resistance. Tests were carried out under a laminar flow cabinet, where two panels of each material were contaminated with a viral suspension. The inocula were left to dry and then the virus on untreated panel (control) was collected by swabbing in order to determine the initial titer. The other panel was treated using a professional vacuum cleaner equipped with a dry steam generator. Dry steam is generated in a boiler where tap water is heated up to 155 °C at 5.5 bar pressure and then during the passage along the flexible hose the temperature decreases to a value between 100 C and 110 C at the output. The dry steam was applied for four sec with a window wiper on metal and plastic panels or a brush covered by a microfiber cap on cotton, simulating the steam application during routine cleaning. After the treatment, infectious virus possibly
remained on the surface was collected following the same swabbing procedure applied for controls. HCoV-OC43 and Echovirus 7 were titrated by end-point method on HCT-8 line cells and Vero cells, respectively, while Human Influenza Virus was quantified by plaque reduction assay on MDCK cells. Dry steam resulted effective against the three viruses on all tested materials, achieving a mean Log10 reduction factor >=4 in viral titer of treated samples compared with controls according to UNI EN 14476:2019. Thus, dry steam may be proposed as an ease to use, effective, fast, and nontoxic alternative to chemicals for surface disinfection without damaging materials. Therefore, this device could be employed not only in healthcare facilities but also in occupational, domestic, and community settings, with advantages for environment and human health.
2021
- Physical and sedentary activities and childhood overweight/obesity: A cross-sectional study among first-year children of primary schools in modena, italy
[Articolo su rivista]
Paduano, S.; Greco, A.; Borsari, L.; Salvia, C.; Tancredi, S.; Pinca, J.; Midili, S.; Tripodi, A.; Borella, P.; Marchesi, I.
abstract
Children obesity is a serious public health issue. This study aimed to investigate physi-cal/sedentary activities of first-year primary schools children in Modena, and their association with overweight/obesity and dietary habits of children and family characteristics to identify the risk factors for unhealthy lifestyles. Child physical/sedentary activities were gathered through an anony-mous questionnaire administered to parents, as well as family characteristics and weight/height of child and parents. Logistic regression models, eventually adjusted for parents’ sociodemographic characteristics, were used to analyze data. Questionnaires were delivered by 660 families (74.2%), of which 72 without anthropometric data were excluded. Three out of four children spent in physical activities less than 7 h/week, while 63.9% dedicated to sedentary activities two or more hours/day. From multivariate analysis, the habit significantly affecting children’s overweight/obesity was spending time on tablets/Personal Computers/mobile phones/videogames. Higher parental education level resulted in a protective factor for implementing unhealthy lifestyles in terms of time dedicated to physical/sedentary activities. Our results suggest the need of interventions to increase time for physical activity and to promote a responsible use of digital media involving the entire families to reach all parents regardless of their education and nationality with a possible relapse on other family members.
2021
- Seroprevalence of anti-SARS-CoV-2 antibodies after the first COVID-19 wave: a cross-sectional study in the province of Modena, city of a Northern Italy region
[Abstract in Rivista]
Berselli, N; Filippini, T; Paduano, S; Malavolti, M; Modenese, A; Gobba, F; Borella, P; Marchesi, I; Vivoli, R; Perlini, P; Bellucci, R; Bargellini, A; Vinceti, M
abstract
2021
- Seroprevalence of anti-SARS-CoV-2 antibodies in the Northern Italy population before the COVID-19 second wave
[Articolo su rivista]
Berselli, Nausicaa; Filippini, Tommaso; Paduano, Stefania; Malavolti, Marcella; Modenese, Alberto; Gobba, Fabriziomaria; Borella, Paola; Marchesi, Isabella; Vivoli, Roberto; Perlini, Paola; Bellucci, Rossana; Bargellini, Annalisa; Vinceti, Marco
abstract
The COVID-19 pandemic is due to SARS-CoV-2 coronavirus infections. It swept across the world in the spring of 2020, and so far it has caused a huge number of hospitalizations and deaths. In the present study, the authors investigated serum anti-SARS-CoV-2 antibody prevalence in the period of June 1-September 25, 2020, in 7561 subjects in Modena, Northern Italy.
2021
- Studio di fattori di rischio/protettivi associati alla risposta anticorpale anti-SARS-CoV-2 in un campione di lavoratori della provincia di Modena e province limitrofe
[Abstract in Rivista]
Paduano, S; Modenese, A; Filippini, T; Berselli, N; Marchesi, I; Vinceti, M; Borella, P; Gobba, F; Bargellini, A
abstract
2020
- Characterisation of Microbial Community Associated with Different Disinfection Treatments in Hospital hot Water Networks
[Articolo su rivista]
Paduano, Stefania; Marchesi, Isabella; Casali, Maria Elisabetta; Valeriani, Federica; Frezza, Giuseppina; Vecchi, Elena; Sircana, Luca; Romano Spica, Vincenzo; Borella, Paola; Bargellini, Annalisa
abstract
Many disinfection treatments can be adopted for controlling opportunistic pathogens in hospital water networks in order to reduce infection risk for immunocompromised patients. Each method has limits and strengths and it could determine modifications on bacterial community. The aim of our investigation was to study under real-life conditions the microbial community associated with different chemical (monochloramine, hydrogen peroxide, chlorine dioxide) and non-chemical (hyperthermia) treatments, continuously applied since many years in four hot water networks of the same hospital. Municipal cold water, untreated secondary, and treated hot water were analysed for microbiome characterization by 16S amplicon sequencing. Cold waters had a common microbial profile at genera level. The hot water bacterial profiles differed according to treatment. Our results confirm the effectiveness of disinfection strategies in our hospital for controlling potential pathogens such as Legionella, as the investigated genera containing opportunistic pathogens were absent or had relative abundances ≤1%, except for non-tuberculous mycobacteria, Sphingomonas, Ochrobactrum and Brevundimonas. Monitoring the microbial complexity of healthcare water networks through 16S amplicon sequencing is an innovative and effective approach useful for Public Health purpose in order to verify possible modifications of microbiota associated with disinfection treatments.
2020
- Corrosion resistance of commonly used plumbing materials for water distribution systems exposed to disinfection treatments
[Articolo su rivista]
Giovanardi, Roberto; Bononi, Massimiliano; Messori, Massimo; Bargellini, Annalisa; Paduano, Stefania; Borella, Paola; Marchesi, Isabella
abstract
In this study, the corrosion resistance of commonly used plumbing materials was evaluated when three disinfection treatments were applied in hot water distribution systems. In particular copper,
brass, stainless steel and galvanised steel were tested in environments containing monochloramine, chlorine dioxide and hydrogen peroxide disinfectants under real field conditions for a long period of time (1 year), in order to evaluate the effect of free corrosion on the metal specimens; chlorinated polyvinylchloride (CPVC) was tested in the same environments in order to evaluate the degradation of the mechanical properties of plastic specimens. The results obtained enabled us to rank the metallic materials corrosion resistance against disinfectants in decreasing order, as follows: stainless steel, copper and copper-based alloys, galvanised steel. CPVC samples proved to be extremely stable in all of the disinfectants investigated, maintaining the same compression behaviour of the pipes aged with untreated water after 12 months of exposure
2020
- Risk Factors for Overweight and Obesity in Children Attending the First Year of Primary Schools in Modena, Italy
[Articolo su rivista]
Paduano, S.; Borsari, L.; Salvia, C.; Arletti, S.; Tripodi, A.; Pinca, J.; Borella, P.
abstract
Over the last four decades, childhood overweight/obesity has dramatically increased, becoming a significant public health concern. The main aims of this study were to investigate the prevalence of overweight/obesity among first-year primary schools children in Modena and to identify the associated risk factors. Data were collected on the socio-demographic characteristics of family and weight, height, dietary habits and sedentary behaviours of the children, and on the parents’ perception of their child’s weight status, through an anonymous questionnaire administered to parents. The questionnaires were delivered by 660 out of 890 (74.2%) families, and after excluding those without anthropometric data, 588 children were included in the study. The prevalence of overweight/obesity among the children was 25.2%, significantly lower in children born to parents with a high education, and higher among children born to foreign parents and overweight/obese mothers. The multivariable analysis showed that the children most likely to become overweight/obese were those who skipped breakfast (OR 2.3, 95%CI 1.3–4.2) and/or mid-morning snacks (OR 3.2, 95%CI 1.5–6.5). Breakfast consumption was positively associated with higher parental education levels, whereas skipping mid-morning snacks is more frequent among children born to foreign parents and overweight/obese mothers. Moreover, 84.7% of the parents of overweight/obese children underestimated their child’s weight status. One in four 6–7 year-old children is already overweight or obese. Childhood overweight/obesity is significantly associated with unhealthy lifestyles and family lifestyle. It is therefore essential to implement public health intervention programs aimed at both parents and children, in order to promote healthy lifestyles in early childhood.
2020
- Safety and effectiveness of monochloramine treatment for disinfecting hospital water networks
[Articolo su rivista]
Marchesi, I.; Paduano, S.; Frezza, G.; Sircana, L.; Vecchi, E.; Zuccarello, P.; Conti, G. O.; Ferrante, M.; Borella, P.; Bargellini, A.
abstract
The formation of potentially carcinogenic N-nitrosamines, associated with monochloramine, requires further research due to the growing interest in using this biocide for the secondary disinfection of water in public and private buildings. The aim of our study was to evaluate the possible formation of N-nitrosamines and other toxic disinfection by-products (DBPs) in hospital hot water networks treated with monochloramine. The effectiveness of this biocide in controlling Legionella spp. contamination was also verified. For this purpose, four different monochloramine-treated networks, in terms of the duration of treatment and method of biocide injection, were investigated. Untreated hot water, municipal cold water and, limited to N-nitrosamines analysis, hot water treated with chlorine dioxide were analyzed for comparison. Legionella spp. contamination was successfully controlled without any formation of N-nitrosamines. No nitrification or formation of the regulated DBPs, such as chlorites and trihalomethanes, occurred in monochloramine-treated water networks. However, a stable formulation of hypochlorite, its frequent replacement with a fresh product, and the routine monitoring of free ammonia are recommended to ensure a proper disinfection. Our study confirms that monochloramine may be proposed as an effective and safe strategy for the continuous disinfection of building plumbing systems, preventing vulnerable individuals from being exposed to legionellae and dangerous DBPs.
2020
- The relevance of molecular genotyping to allocate cases in a suspected outbreak of Legionella pneumonia in patients with prolonged immunosuppressive therapy
[Articolo su rivista]
Borella, Paola; Vecchi, Elena; Incerti, Federica; Marchesi, Isabella; Meacci, Marisa; Frezza, Giuseppina; Fregni Serpini, Giulia; Mansi, Antonella; Paduano, Stefania; Bargellini, Annalisa
abstract
Three cases of pneumonia by L. pneumophila serogroup 1 (Lp1) in immunosuppressed patients with repeated hospitalization were suspected as a healthcare-associated cluster. The environmental investigation did not reveal the presence of legionellae in the hospital patient's rooms. Water samples collected from the home of two patients were also negative for Legionella spp. In the absence of environmental strains potentially involved in the infections, we proceeded to genotype environmental Lp1 strains isolated in the hospital during the routine water sampling along the decade 2009-2019 and recovered after long term storage at -20 °C. These "historical" strains exhibited high grade of similarity and stability over time, regardless of disinfection systems. The different molecular profile showed among clinical and environmental strains excluded a nosocomial outbreak. The study suggests that the application of molecular typing may be a useful tool to discriminate hospital vs community-acquired cases, mostly for severely immunosuppressed patients in which the symptomatology could be insidious and the incubation period could be prolonged. Moreover, the genotyping allowed us to exclude that the cases were linked each other's.
2020
- [The Health Examination Survey at regional level: the Emilia-Romagna Region (Northern Italy) example]
[Articolo su rivista]
Salvia, Chiara; Donfrancesco, Chiara; Palmieri, Luigi; Lo Noce, Cinzia; Vanuzzo, Diego; Vinceti, Marco; Bargellini, Annalisa; Borella, Paola; Giampaoli, Simona
abstract
to assess time trend of lifestyles, cardiovascular risk factors, and prevalence of high-risk conditions in random samples of the general adult population residing in Emilia-Romagna, examined in two cross-sectional surveys conducted within the Epidemiological Cardiovascular Observatory (OEC 1998-2002) and the Epidemiological Cardiovascular Observatory/Health Examination Survey (OEC/HES 2008-2012).
2019
- Difficoltà nella identificazione della fonte ambientale di Legionella: un esempio dalla pratica clinica di casi comunitari inizialmente classificati come nosocomiali
[Abstract in Atti di Convegno]
Borella, P.; Vecchi, E.; Incerti, F.; Marchesi, I.; Cagarelli, R.; Pecorari, M.; Bargellini, A.; Frezza, G.; Barbieri, M.; Paduano, S.
abstract
Introduzione
I casi di polmonite da Legionella sono in aumento in tutto il mondo in parte per la maggior capacità diagnostica, in parte per la molteplicità delle possibili fonti di contagio, con comparsa sempre più frequente di focolai epidemici, la cui origine è spesso difficile da identificare. In Germania, come in altre realtà europee, sono state sospettate come reservoirs le torri di raffreddamento, ma la connessione con i casi raramente è stata possibile. Per quanto riguarda casi singoli o clusters epidemici eventualmente contratti in strutture di ricovero e cura, l'associazione con la contaminazione ambientale viene effettuata sulla base del periodo di incubazione della malattia, anche se la complessità clinica dei pazienti rende talora difficile stabilire l'esordio dei sintomi. In questo studio, riportiamo alcuni casi di polmonite da Legionella diagnosticati nel Policlinico Universitario di Modena, inizialmente classificati come nosocomiali, ipotesi poi smentita da un approfondimento sulle caratteristiche molecolari dei ceppi clinici e ambientali.
Materiali e Metodi
Nel periodo aprile e maggio 2018, sono stati diagnosticati tramite ricerca dell’antigene urinario tre casi di polmonite da Legionella in pazienti immunodepressi con importanti co-morbilità, il cui ricovero era compatibile con il periodo di incubazione della malattia. Sono state condotte analisi colturali sui campioni idrici nei reparti e stanze in cui i pazienti avevano soggiornato e si è provveduto all’isolamento colturale del microorganismo su espettorato, con successiva analisi di tipizzazione molecolare con metodica RAPD-PCR e Sequence-Based Typing (SBT). I ceppi isolati dai pazienti sono stati confrontati con ceppi ambientali isolati e conservati al Policlinico. Le indagini disposte dalla Direzione Ospedaliera sono state condotte nei laboratori dell'Università e in parallelo dal Servizio di Igiene e Sanità Pubblica che ha anche disposto verifiche nelle abitazioni dei pazienti.
Risultati
L'esame colturale dell'escreato dei tre pazienti è risultato positivo per L. pneumophila (Lpn) sierogruppo (sg) 1. Dall’analisi di genotipizzazione, i ceppi isolati dai pazienti presentano profili SBT diversi (ST 18, ST2632, ST263 l) con basso grado di similarità. Le indagini ambientali condotte nell’ospedale e nelle abitazioni sono risultate tutte negative. L'analisi molecolare di dieci ceppi storicamente isolati nel Policlinico ha riscontrato in tutti Lpn ST1, con alto grado di similarità tra loro, ma dissimili dai ceppi clinici.
Conclusioni
I casi riportati evidenziano la difficoltà di definire come nosocomiali polmoniti da Legionella che insorgono in pazienti complessi, ricoverati a più riprese in ospedale. Lo studio delle caratteristiche molecolari dei ceppi clinici e ambientali ci ha permesso infatti di classificarli come casi singoli di origine comunitaria, diversi l'uno dall'altro e non inquadrabili come un cluster di origine nosocomiale. Nell'ospedale, tutte le fonti idriche sono risultate legionella-free, anche grazie ai sistemi di disinfezione adottati da tempo, e la mancata similarità tra i tre ceppi clinici e quelli isolati e conservati nella ceppoteca ospedaliera ha confermato che si trattava di microrganismi estranei alla struttura. Lo studio mette in evidenza la possibilità di slittamenti temporali nel periodo di incubazione della polmonite da Legionella, particolarmente in pazienti gravemente compromessi, e ciò rende problematica la ricerca delle fonti del contagio sia nelle polmoniti nosocomiali che in quelle comunitarie
2019
- Educazione alla salute nelle scuole primarie: progetto pluriennale per una sana alimentazione. J Prev Med Hyg. 2019 September; 60(3) S1: E218.
[Abstract in Rivista]
Paduano, S; Borsari, L; Salvia, C; Arletti, S; Tripodi, A; Pinca, J; Borella, P
abstract
2019
- Genotipizzazione molecolare di Legionella come strumento dirimente un sospetto cluster nosocomiale. J Prev Med Hyg. 2019 September; 60(3) S1: E303.
[Abstract in Rivista]
Borella, P; Incerti, F; Marchesi, I; Bargellini, A; Paduano, S; Vecchi, E; Barbieri, M; Pecorari, M; Fregni Serpini, G; Grottola, A; Cagarelli, R
abstract
2019
- Mobile health system to improve maternal and neonatal health: an interventional trial in Mufindi district, Tanzania. J Prev Med Hyg. 2019 December; 60(4) S3: E44.
[Abstract in Rivista]
Paduano, S; Borsari, L; Incerti, F; Bovolenta, V; Bisi, Mt; Benski, C; Borella, P.
abstract
2019
- Nuovo approccio metodologico per valutare l’efficacia antibatterica di materiali nanostrutturati da impiegare quali misure di protezione collettiva in ambito sanitario. J Prev Med Hyg. 2019 September; 60(3) S1: E211
[Abstract in Rivista]
Mansi, A; Paba, E; Amori, I; Marcelloni, Am; Proietto, Ar; Chiominto, A; Paduano, S; Marchesi, I; Frezza, G; Borella, P; Stanzione, M; Buonocore, Gg; Lavorgna, M; Ambrosio, L; Iavicoli, S
abstract
2019
- Studio dell’impatto di diverse strategie di disinfezione sulla comunità microbica delle reti idriche ospedaliere tramite l’applicazione della genomica.
[Abstract in Atti di Convegno]
Paduano, Stefania; Casali, Maria Elisabetta; Marchesi, I; Frezza, G.; Valeriani, F.; Romano-Spica, V.; Vecchi, E.; Borella, P.; Bargellini, Annalisa
abstract
Introduzione. La maggior parte delle strutture sanitarie applica al sistema idrico trattamenti di disinfezione in continuo al fine di ridurre il rischio infettivo. Tali trattamenti possono modificare la composizione della comunità batterica dei sistemi di distribuzione dell'acqua sia in termini di abbondanza che di varietà di genere. Le tecnologie NGS (Next Generation Sequencing) e gli strumenti bioinformatici utilizzati negli studi di metagenomica consentono di rilevare tutti i batteri coltivabili e non, appartenenti alla comunità microbica della rete idrica indagata, sequenziando segmenti del loro DNA. Scopo dello studio è valutare l’impatto di diversi trattamenti di disinfezione sulla comunità microbica presente nelle reti di distribuzione dell’acqua calda dell’Azienda Ospedaliero-Universitaria di Modena tramite queste tecnologie.
Materiali e metodi. L’ospedale oggetto dello studio comprende un monoblocco principale e quattro palazzine separate provviste ciascuna della propria centrale idrica. Tutti gli edifici sono alimentati da acqua fredda clorata proveniente dall’acquedotto comunale. Sono stati raccolti campioni di acqua fredda in ingresso (in due sessioni di campionamento a distanza di un anno) e di acqua calda da ricircoli e punti distali di quattro reti idriche, di cui tre trattate con diversi biocidi (monocloramina, perossido di idrogeno e biossido di cloro) e una rete non trattata chimicamente. Ogni campione è stato analizzato per la caratterizzazione del microbioma tramite NGS.
Risultati. Le acque fredde in ingresso presentavano profili microbici comuni, confermati nella loro similitudine anche a distanza di un anno dal primo campionamento. Nello specifico, Proteobacteria e Bacteroidetes rappresentavano i phyla predominanti e Burkholderia, Sediminibacterium, e Bradyrhizobium i generi prevalenti e comuni a tutte queste acque. Nelle reti idriche trattate predominavano alcuni generi resistenti a condizioni ambientali sfavorevoli quali Bradyrhizobium (rete trattata con perossido di idrogeno e biossido di cloro), Mycobacterium (perossido di idrogeno), Gallionella (monoclorammina) e Blastomonas (biossido di cloro). Generi termofili (Thermobaculum) predominavano invece nelle acque non trattate chimicamente che avevano una temperatura più elevata (>50°C) rispetto alle reti trattate tenute tra 40°C e 45°C per evitare la degradazione dei biocidi stessi. In tutti i campioni, Legionella spp e Pseudomonas spp risultavano inferiori all’1% sul totale dei generi identificati.
Conclusioni. La caratterizzazione dei profili microbici delle reti idriche ospedaliere mediante l’analisi metagenomica rappresenta un approccio innovativo nella sua applicazione in Sanità Pubblica. Tutti i sistemi di disinfezione studiati sono risultati efficaci nel controllare la contaminazione da Legionella e Pseudomonas all’interno delle reti idriche ospedaliere. I nostri risultati suggeriscono un impatto diverso dei tre biocidi sui profili batterici delle acque calde, selezionando alcuni generi resistenti a stress ossidativi e limitatamente alla rete trattata con perossido di idrogeno patogeni opportunisti appartenenti al genere Mycobacterium. Ulteriori indagini sarebbero necessarie per monitorare nel tempo la stabilità della comunità microbica nelle reti idriche trattate.
2019
- Vantaggi e svantaggi di diversi biocidi nel controllo della contaminazione da Legionella in ospedale
[Abstract in Atti di Convegno]
Marchesi, I.; Bargellini, A.; Paduano, S.; Frezza, G.; Mansi, A.; Giovanardi, R.; Vecchi, E.; Borella, Paola
abstract
Introduzione. Per il controllo della contaminazione idrica da Legionella, vengono proposti vari sistemi di disinfezione che richiedono una valutazione non solo dell’efficacia ma anche dei possibili effetti collaterali. Obiettivo dello studio è valutare l'efficacia nel lungo periodo di diversi trattamenti adottati in strutture sanitarie in termini di riduzione della contaminazione, presenza di legionelle vitali ma non coltivabili (VBNC), formazione di sottoprodotti tossici ed i possibili effetti corrosivi. Materiali e Metodi. Lo studio è stato condotto in strutture sanitarie del territorio modenese nelle quali sono attivi programmi di sorveglianza e controllo della legionellosi secondo le raccomandazioni delle linee guida regionali. Tali programmi prevedono l’adozione di sistemi di disinfezione in continuo (biossido di cloro, monoclorammina, perossido di idrogeno) ed il monitoraggio periodico della contaminazione degli impianti idrosanitari. Legionella spp. è stata quantificata tramite coltura (metodo ISO 11731:2017) ed identificata a livello di specie e sierogruppo. Per oltre 150 campioni, i risultati ottenuti con il metodo colturale sono stati confrontati con quelli ottenuti con la qPCR convenzionale ed il metodo EMA-qPCR che consente di rilevare l’eventuale presenza di legionelle VBNC. La concentrazione dei biocidi ed altri parametri chimico-fisici dell’acqua quali temperatura, pH, cloriti, clorati, ammonio, nitriti, nitrati, N-nitrosammine, e trialometani sono stati misurati con metodi standard. Per valutare l’eventuale effetto corrosivo dei biocidi, supporti di polivinilcloruro clorurato (PVC-C) contenenti provini di materiali utilizzati per le tubazioni/rubinetterie (rame, ottone, acciaio zincato e acciaio inossidabile) sono stati collegati al ricircolo di tre reti trattate in continuo con disinfettanti e di una non trattata. Dopo tre, sei e dodici mesi di esposizione, la corrosione dei provini metallici è stata valutata in termini di perdita di peso, mentre i supporti in PVC-C sono stati sottoposti a schiacciamento per valutarne la resistenza meccanica all’esposizione ad acqua trattata.
Risultati. La monoclorammina ha dimostrato una maggiore efficacia nel controllo della contaminazione rispetto a biossido di cloro e perossido di idrogeno. Con i trattamenti a base di cloro, i punti positivi sono risultati contaminati da L. pneumophila sierogruppo 1, mentre col perossido erano prevalenti altre specie/sierogruppi. Nelle acque trattate con i biocidi allo studio non sono state rilevate legionelle VBNC. La formazione di cloriti e clorati è stata associata all’uso di biossido di cloro, mentre con la monoclorammina non sono stati osservati fenomeni di nitrificazione né formazione di nitrosammine. Tutti i biocidi hanno causato effetti corrosivi, anche se per i metalli testati la velocità di corrosione era entro 0,50 mm/anno, valore considerato soddisfacente per le reti idriche. Il PVC-C ha mantenuto inalterate le sue caratteristiche meccaniche anche in presenza dei disinfettanti.
Conclusioni. La disinfezione chimica in continuo si conferma efficace nel ridurre ma non eradicare le legionelle dagli impianti evitando anche la presenza di cellule vitali ma non coltivabili potenzialmente infettive. Ogni metodo ha dei limiti in termini di aggressività, tossicità e selezione di ceppi, che devono essere attentamente valutati al momento della scelta del disinfettante da adottare.
2018
- An Innovative Mobile Health System to Improve and Standardize Antenatal Care Among Underserved Communities: A Feasibility Study in an Italian Hosting Center for Asylum Seekers
[Articolo su rivista]
Borsari, Lucia; Stancanelli, Giovanna; Guarenti, Laura; Grandi, Teresa; Leotta, Serena; Barcellini, Lucia; Borella, Paola; Benski, Anne Caroline
abstract
Innovative migrant-friendly tools are needed to assist health personnel manage the high number of pregnancies within reception centers. This study tests functionality and acceptability of a new mHealth system in providing antenatal care amongst migrants. The study, carried out between 2014 and 2016, involved 150 pregnant women residing in the largest European migrant reception center in Sicily. A ticket tracking system assessed the system’s functionality and a questionnaire assessed women’s acceptability. The system facilitated the collection of clinical data, enabling the creation of electronic patient records and identifying 10% of pregnancies as high-risk. The application’s digital format increased health providers’ adherence to antenatal-care recommendations, while the graphic interface facilitated women’s engagement and retention of the health education modules. The study recorded a 91.9% patient satisfaction rate. The system was efficient in providing comprehensive and high-quality antenatal care amongst migrants, facilitating the continuity of care for a population undergoing frequent relocations.
2018
- Microbial biodiversity of thermal water and mud in an Italian spa by metagenomics: a pilot study
[Articolo su rivista]
Paduano, Stefania; Valeriani, Federica; Romano-Spica, Vincenzo; Bargellini, Annalisa; Borella, Paola; Marchesi, Isabella
abstract
In literature, the microbial diversity of hot spring waters has been the focus of extensive research, while there is a paucity of studies on thermal water distribution network of spa centres and as yet no studies have been carried out on the bacterial population of thermal muds. In this context, the aim of our study is to characterize the microbial community of sulphurous-bromine-iodine thermal water and mud within an Italian spa complex using Next Generation Sequencing (NGS) technologies. This is the first report of microbiome characterization along a water supply network from the spring to points of use within a spa. According to the 16S rRNA gene sequences analysis, our data highlight the presence of a typical microbial community, mainly composed of sulphur-cycling bacteria belonging to Desulfomonile, Thermodesulfovibrio, Geothermobacterium, Thermus, Thiofaba and Syntrophomonas genera. In addition, the characterization and evolution of the bacterial community in thermal muds during the maturation process is investigated for the first time. Interestingly, the microbiome of mature mud resulted dominated by bacteria capable of lipid biosynthesis, suggesting that these bacteria may play a role in the anti-rheumatic properties of thermal mud.
2018
- Trace elements in starter infant formula: dietary intake and safety assessment
[Articolo su rivista]
Bargellini, Annalisa; Venturelli, Francesco; Casali, Elisabetta; Ferrari, Angela; Marchesi, Isabella; Borella, Paola
abstract
The aim of this study was to investigate the concentrations of five essential (Fe, Mn, Zn, Cu and Se) and four non-essential/toxic elements (Cr, Cd, Ni and Pb) in 35 different starter infant formulas (0-6 months) sold in Italy. In addition, a safety assessment of these trace elements was carried out, by comparing the estimated daily intake (EDI) with the adequate intake (AI) and the provisional tolerable daily intake (PTDI), with a view to provide information on the metal distribution patterns and health risk to infants arising from the consumption of these products. The concentrations were determined by using inductively coupled plasma mass spectrometry after microwave digestion. The concentrations expressed in geometric mean ± geometric standard deviation of Fe (6.17 ± 1.61 mg/L), Zn (6.21 ± 1.31 mg/L), Cu (416.4 ± 1.21 μg/L), Mn (121.5 ± 1.85 μg/L) and Se (13.27 ± 1.67 μg/L) were within legal limits. In spite of this, the mean EDIs of Fe (4.81 mg/day) and Mn (94.75 μg/day) were many times higher than the recommended AI, especially for Mn. Chromium, Ni, Cd and Pb concentrations were not detectable in 11, 37, 57 and 66% of the samples, respectively. Considering the overall sample, the GM ± GSD of these elements were 4.80 ± 5.35 μg/L for Cr, 1.02 ± 11.65 μg/L for Ni, 0.21 ± 14.83 μg/L for Cd and 0.14 ± 17.13 μg/L for Pb. The mean EDIs were far below the respective PTDI. When the safety assessment was based on the 75° percentile level of each elements, all EDIs remained well below the PTDI, with the exception of Cd, whose EDI approached (74.7%), albeit remaining below the PTDI. In conclusion, our results and the increased awareness on the potential risks of excessive Mn and Fe for infants support that an urgent scientific-based definition of the appropriated levels of fortification in formulas is required. Moreover, regular monitoring of all the stages of production of infant formulas is essential in order to limit toxic metal contamination.
2017
- Comparison of breast milk and infant formulas in essential and toxic elements content
[Abstract in Atti di Convegno]
Bargellini, A; Marchesi, I; Fantuzzi, G; Righi, E; Pescarolo, Letizia; Ferrari, A; Paduano, Stefania; Borella, P
abstract
Background and aim: Human milk is considered to be the best source of nutrition for the newborn infants, and exclusive breastfeeding is recommended by WHO up to 6 months of age. It contains all the nutrients and essential trace elements necessary to ensure correct functioning of the organism. Sometimes, breast milk may be a potential source of undesirable (toxic) elements as their content reflects the level of environmental pollution and mother’s diet. In developed countries, the most common substitutes for human milk are commercially available infant formulas. Nutrient levels in formulas are generally modeled on the composition of human milk with the aim to make them similar. Relatively few recent data on breast milk which can be used as background data for setting adequate daily intakes for infants, are available from women living in Italy. The aim of this study was to determine the levels of five essential (Fe, Zn, Cu, Mn, Se, Cr) and four non-essential/toxic elements (Ni, Cr, Cd, Pb) in breast milk of women living in Modena, Italy; to compare them with recommended values; to investigate the relationship with diet and mother characteristics; to compare them with infant formulas.
Methods: 130 samples of human milk (mature milk: 30-40 days postpartum) and a representative sample of infant formulas (0–6 months) sold in Italy were analyzed by ICP-MS in triplicate after microwave digestion.
Results: Mature breast milk contains adequate levels of essential trace elements, despite the inter-individual variability not influenced by the women characteristics, demographic parameters and dietary habits. Non-essential/toxic elements content was well below the maximum tolerable limits set by EFSA. Regarding infant formulas, higher amounts of Fe and Mn were observed in comparison to breast milk.
Conclusions: This study highlights that the levels of essential micronutrient in lactating women living in Modena are suitable for the proper development of infants and no risk for excessive toxic elements intake was detected. Comparison with infant formulas shows that high fortification with Fe and Mn requires more attention by researcher and international authorities. According to our findings, breastfeeding should be still encouraged and recommended.
2017
- Corrosive effect on various pipe materials following different treatments for Legionella spp control in hospital water systems
[Abstract in Atti di Convegno]
Marchesi, I; Paduano, S; Giovanardi, R; Bonomi, Marco; Sircana, L; Vecchi, E; Bargellini, A; Borella, P.
abstract
The aim of this study is to verify the long term corrosive effect of three disinfection procedures on different commonly used plumbing materials, in hospital water networks
2017
- DETERMINAZIONE DI ENDOCRINE DISRUPTORS NEL LATTE MATERNO IN UN CAMPIONE DI DONNE DELLA PROVINCIA DI MODENA – RISULTATI PRELIMINARI DI UNO STUDIO EPIDEMIOLOGICO TRASVERSALE
[Abstract in Atti di Convegno]
Scelsa, F; Righi, E; Fantuzzi, G; Predieri, G; Bargellini, A; Borella, P; Aggazzotti, G
abstract
INTRODUZIONE: Gli ftalati, diesteri dell’acido ftalico, appartenenti alla categoria degli endocrine disruptors, sono un problema emergente per quanto riguarda l’allattamento, a causa della loro presenza, talvolta in concentrazioni elevate, nel latte materno evidenziata in alcuni recenti studi. Si tratta di sostanze di sintesi ampiamente utilizzate per la produzione di oggetti plastici, imballaggi, prodotti biomedicali e per la cura e l’igiene personale. I livelli che raggiungono nel latte sono influenzati dalle abitudini e dall’ambiente di vita della donna. Lo scopo dello studio è di determinare le concentrazioni di ftalati nel latte materno di puerpere residenti a Modena e Provincia e di evidenziare potenziali differenze nei loro livelli in relazione alle diverse fonti di esposizione, alle abitudini e alle caratteristiche delle donne stesse.
MATERIALI E METODI: A 130 puerpere (età media: 33, range: 19-45 anni), arruolate su base volontaria, è stato chiesto di fornire un campione di latte (20 ml) a 30-40 giorni dal parto e di rispondere ad un questionario sulle principali caratteristiche demografiche e sulle possibili fonti espositive ai contaminanti indagati. Il latte raccolto, previa estrazione dispersiva in fase solida (d-SPE), è stato analizzato in cromatografia liquida ad alte prestazioni con rivelatore a spettrometria di massa tandem - triplo quadrupolo (HPLC/MS/MS).
RISULTATI: Il composto più diffuso è risultato il mono-iso-nonilftalato (MiNP) ritrovato in 125 campioni (media: 1,63±2,71 range 0,10-18,4 μg/l), seguito dal mono-etilftalato (MEP) rilevato in 106 campioni (media: 2,35±7,36 range 0,04-69,00 μg/l). Le concentrazioni rilevate sono apparse più elevate nei latti delle donne che fanno maggior uso di cosmetici e che hanno consumato alimenti e bevande confezionati in plastica durante l’allattamento. Le differenze tuttavia non sono apparse statisticamente significative. Gli ftalati diesteri, come conseguenza della loro trasformazione metabolica in monoesteri, sono risultati quasi totalmente assenti.
CONCLUSIONI: Non è stato evidenziato, nel nostro territorio, un problema rilevante di salute legato all’assunzione di ftalati con l’allattamento al seno
2017
- ELEMENTI IN TRACCIA NEL LATTE MATERNO: STUDIO ANALITICO TRASVERSALE SU UN CAMPIONE DI DONNE DELLA PROVINCIA DI MODENA
[Abstract in Atti di Convegno]
Pescarolo, L.; Fantuzzi, G.; Righi, E.; Ferrari, A.; Marchesi, I.; Borella, P.; Bargellini, A.
abstract
INTRODUZIONE:
L’allattamento al seno rappresenta la miglior fonte di nutrimento per i neonati di tutto il mondo tanto che l’OMS ne
raccomanda l’esclusività fino al 6° mese di vita del bambino. Il latte umano fornisce tutte le sostanze nutritive, tra cui
elementi essenziali in traccia, necessarie al corretto funzionamento dell’organismo del neonato. Tuttavia, può anche
essere una potenziale fonte di elementi tossici, pericolosi per la salute del neonato, ed il loro contenuto può riflettere sia
il livello di inquinamento ambientale che la dieta della madre. Scopo dello studio è quello di determinare nel latte materno
di un campione rappresentativo di donne sane residenti a Modena e Provincia le concentrazioni di 5 microelementi
essenziali come Fe, Zn, Cu, Mn, Se, di 2 elementi non essenziali come Ni e Cr e di due elementi tossici di grande
rilevanza per il bambino come Pb e Cd, al fine di ottenere dati aggiornati ed aumentare le conoscenze riguardanti
l’esposizione neonatale a tali elementi attraverso l’allattamento.
MATERIALI E METODI:
I campioni di latte materno sono stati raccolti tra il 30esimo e il 40esimo giorno post partum e le concentrazioni degli
elementi in traccia sono state determinate attraverso ICP-MS, previa digestione con microonde. Sono state raccolte
informazioni sulle abitudini alimentari materne e sui parametri socio-demografici.
RISULTATI:
130 campioni di latte sono stati analizzati. Nonostante l’ampia variabilità inter-individuale, le concentrazioni medie di
elementi in traccia essenziali risultano in linea con i valori raccomandati e il contenuto di elementi non essenziali/
tossici è ampiamente al di sotto dei limiti massimi tollerabili (PTDI) stabiliti dall’EFSA e dagli altri organi competenti. Le
differenze osservate con altri studi possono essere attribuite al momento di raccolta del campione, a fattori ambientali o
a differenze nella valutazione analitica.
CONCLUSIONI:
Possiamo confermare che i latti analizzati in questo studio contengono i livelli di micronutrienti essenziali adatti al
corretto sviluppo del neonato e che l’allattamento al seno costituisce un metodo sicuro per l’alimentazione del neonato.
2017
- EMA-qPCR: a rapid technique for managing the risk of Legionella spp in waters subjected to disinfection treatments
[Abstract in Atti di Convegno]
Mansi, A; Marchesi, I; Amori, I; Marcelloni, Am; Proietto, Ar; Bargellini, A; Paduano, S; Borella, P.
abstract
The aim of this study is to evaluate the advantages of this method in evaluating the presence of Legionella spp in water compared with both culture and qPCR
2017
- Effectiveness of monochloramine at different dosage in reducing Legionella water contamination avoiding formation of potentially toxic by-products
[Abstract in Atti di Convegno]
Paduano, S; Marchesi, I; Vecchi, E; Saini, N; Bolognesi, A; Borella, P; Sircana, L; Bargellini, A.
abstract
This study evaluates the efficac of monchloramine in reducing Legionella pneumophila contamination without formation of toxic by-products
2017
- Report on the 6th international FESTEM symposium on “New horizons on trace elements and minerals role in human and animal health” (Catania, Sicily, Italy, May 26–28th, 2016)
[Relazione in Atti di Convegno]
Borella, P.; Michalke, B.
abstract
2017
- Trace element concentrations in breast milk
[Abstract in Rivista]
Borella, Paola; Fantuzzi, Guglielmina; Righi, Elena; Marchesi, Isabella; Ferrari, Angela; Paduano, Stefania; Bargellini, Annalisa
abstract
Breast milk is the best source of nutrition for the newborn infant, and exclusive breast feeding is recommended by WHO up to 6 months of age. Human milk provides all the nutrients including essential trace elements, Conversely, human milk can also be a potential source of undesirable (toxic) elements which are dangerous for a baby, and their content reflects the level of environmental pollution and the mother’s diet.
The aim of this study is to provide updated information on concentrations of a wide range of essential, non-essential and toxic elements in human milk collected from a significant group of healthy lactating women living in Modena, Italy, together with information on dietary habits. Samples were collected between day 30 and 40 after childbirth, and the trace element concentrations were determined by inductively coupled plasma mass spectrometry (ICP-MS) after microwave digestion.
Preliminary results show that concentrations in human milk of some essential trace elements like Fe, Zn, Cu, Se and Mn are in line with reference standard (WHO 1989). No detectable levels of Pb were found, whereas concentrations of Cd were detected in more than one third of mother’s milk samples, although none in amounts that could represent a health hazard.
2017
- Trace element concentrations in breast milk. Journal of Trace Elements in Medicine and Biology 41S (2017) 1–88.
[Abstract in Rivista]
Borella, P; Fantuzzi, G; Righi, E; Marchesi, I; Ferrari, A; Paduano, S; Bargellini, A
abstract
2016
- CONCENTRATIONS OF ESSENTIAL AND TOXIC ELEMENTS IN HUMAN MILK AND INFANT FORMULAS
[Abstract in Atti di Convegno]
Bargellini, Annalisa; Venturelli, Francesco; Casali, Maria Elisabetta; Ferrari, Angela; Reghizzi, J; Fagioli, F; Pedrazzi, Marcello; Borella, Paola
abstract
Human milk represents the most suitable pattern of nutrients to meet the physiological requirements of the young infant and exclusive breast feeding is recommended up to 6 months of age. When breast feeding is not possible, infant formulas are often used as substitutes for human milk, hence, an accurate knowledge of their composition, also in term of trace elements, is essential to understand if the nutrient requirements of the infant fed with formulas are adequate.
Essential trace elements play a relevant role in growth and development. Although they are required only in small amounts, the intake may not always be adequate, and their amount in formula composition has received insufficient attention. Moreover, infant formula and human milk may hold toxic elements as a result of environment pollution or food processing. The main objective of this study is to compare the total concentrations of Fe, Zn, Cu, Mn, Se, Cr, Ni, Cd and Pb in a representative sample of infant starting (0-6 months) formulas consumed in Italy (n=35) with just as many breast milk samples of healthy lactating women from Modena (Italy) and collected on 30 day postpartum.
The element concentrations were determined by ICP-MS after microwave digestion. The levels of essential elements in infant formulas were within min/max of recommended values established by the European directives. Concentrations of Pb and Cd were detected in some infant formulas, although none in amounts that could represent a health hazard for the consumer.
As expected Cu, Fe, Zn and Mn are significantly higher in all investigated formulas compared to breast milk, due to fortification associated with their poor absorption from artificial products. Growing evidence of negative effects on cognitive development from excessive Mn intake suggests a reconsideration on the real need to fortify commercial human-milk substitutes to high concentrations, in order to ensure infant health
2016
- Control of Legionella contamination and risk of corrosion in hospital water networks following various disinfection procedures
[Articolo su rivista]
Marchesi, Isabella; Ferranti, Greta; Mansi, Antonella; Marcelloni, Anna M; Proietto, Anna R; Saini, Navneet; Borella, Paola; Bargellini, Annalisa
abstract
Physical and chemical disinfection methods have been proposed with the aim of controlling Legionella water contamination. To date, the most effective procedures for reducing bacterial contamination have not yet been defined. The aim of this study is to assess the long-term effectiveness of various disinfection procedures in order to reduce both culturable and not culturable (NC) legionellae in different hospital water networks treated with heat, chlorine dioxide, monochloramine and hydrogen peroxide. The temperature levels and the biocide concentrations that proved to obtain reliable results were analysed. In order to study the possible effects on the water pipes, we verified the extent of corrosion on experimental coupons after applying each method for six months. The percentage of positive points was at its lowest after treatment with monochloramine, followed by chlorine dioxide, hydrogen peroxide and hyperthermia. A different selection of Legionella spp was observed, as networks treated with chlorine-based disinfectants were mainly contaminated by L. pneumophila serogroup 1, hyperthermia was associated with the serogroups 2-14 and hydrogen peroxide mainly with non-pneumophila species. NC cells were only detected in heat-treated waters, also when the temperature was approximately 60°C. The corrosion rate of the coupons was within a satisfactory limit for water networks, but the morphology changed. We confirm that chemical disinfection controls Legionella colonization more effectively than hyperthermia. Monochloramine was the most effective treatment, while hydrogen peroxide could be a promising alternative to chlorine-based disinfectants due to its ability to select for other less virulent or non-pathogenic species.
2016
- Hospital-acquired Legionella infections: an update on the procedures for controlling environmental contamination
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; Marchegiano, Patrizia; Vecchi, Elena; Marchesi, Isabella
abstract
The waterborne healthcare-associated infections are mainly sustained by Legionella and Pseudomonas spp. Various water factors and plumbing characteristics, and the interaction with other water microorganisms are considered to be predictive of Legionella contamination. It is therefore mandatory to organize plans of surveillance, prevention and control in order to avoid disease appearance in immunosuppressed patients, with higher risk of death. Guidelines for the prevention of Legionnaires' disease have been published, benefiting those who face this problem, but definitive standardized solutions do not exist yet. Here we describe fifteen years of activity, during which our study group gathered interesting data on the control of Legionella contamination. Water disinfection is not generally sufficient to control the risk of infection, but a complex water safety plan should be developed, including system maintenance, training of staff and implementation of a clinical surveillance system aimed at early detection of cases. Concerning the control measures, we evaluated the effectiveness of different treatments suggested to reduce Legionella spp contamination, comparing our results with the current literature data. The performance ranking was highest for the filter, followed by boilers at high temperature, monochloramine and, at a lower level, chlorine dioxide; the effectiveness of hyperchlorination was limited, and thermal shock was even more ineffective.
2016
- Legionella: la paura dell'acqua calda
[Capitolo/Saggio]
Borella, Paola; Paduano, Stefania; Saini, Navneet; Bargellini, Annalisa; Marchesi, Isabella
abstract
Questo volume che vede la collaborazione di molti studiosi affronta da diversi punti di vista un tema che è sempre stato di grande interesse per l'igiene e la sanità pubblica. Parlare di acqua significa affrontare un tema multiforme con aspetti che non riguardano esclusivamente la sicurezza e la prevenzione delle malattie ma comprende anche aspetti di promozione della salute, di tutela dell'ambient, di gestione economica del ciclo idrico integrato. Nello specifico in questo capitolo viene affrontato il problema Legionella.
2016
- The epidemiology of selenium and human health.
[Capitolo/Saggio]
Vinceti, M; Burlingame, B; Filippini, T; Naska, A; Bargellini, A; Borella, P.
abstract
.
2015
- Lifestyle and food habits changes after migration: a focus on immigrant women in Modena (Italy)
[Articolo su rivista]
Casali, Maria Elisabetta; Borsari, Lucia; Marchesi, Isabella; Borella, Paola; Bargellini, Annalisa
abstract
Background: This study aimed to explore post-migration lifestyle and weight changes in a sample of migrant women recruited in Modena, Italy. Taking into account the importance of the perceived personal susceptibility in improving prevention and treatment seeking behaviors, we further investigated women’s self-recognition of overweight/obesity. We also examined the changes in self-perceived quality of life after the arrival in Modena.
Methods: A cross-sectional study was conducted among 97 female migrants visiting a family counseling in Modena. Socio-demographic information, post-migration changes in lifestyle, dietary habits and selfperceived
quality of life were obtained by administering an anonymous questionnaire, created ad hoc with expert consultation and previously tested in a pilot study. Thereafter blood pressure, height and weight were measured.
Results: More than half of the sample met criteria for overweight/obesity and 58% reported a weight increase after the arrival in Italy. The increased risk of weight gain after migration was significantly associated with
women age, lower education level, African ethnicity and post-migration increased consumption of cheese and snacks/sweets. After applying a conditional multiple logistic regression, ethnicity, age and increased
post-migration cheese consumption remained the main predictors of weight gain. More than half of subjects with BMI ≥25 Kg/m2 were not aware of their own overweight or obesity. Such weight underestimation was
more common in African migrants than in other ethnicities. Findings about the perceived quality of life showed an overall improved economic situation, although more than half of women revealed deterioration
in their social relationships after migration.
Conclusions: Our results are important to identify the gaps in the current migrant populations’ health promotion in Modena and suggest that strategies to support female migrants to reinforce good dietary patterns
may be the key in preventing unhealthy weight gain. Indeed, understanding immigrant women’s culture, beliefs and traditions of their country of origin, as well as food acculturation, is essential to improve the
efficiency of these interventions.
2015
- Selenium in humans: which is the safe range of intake?
[Abstract in Atti di Convegno]
Vinceti, Marco; Filippini, Tommaso; Violi, Federica; Malavolti, Marcella; Malagoli, Carlotta; Bargellini, Annalisa; Borella, Paola
abstract
Selenium in humans: which is the safe range of intake?
2015
- TRACE ELEMENTS IN INFANT MILK
[Abstract in Atti di Convegno]
Bargellini, Annalisa; Elisabetta, Casali; Ferrari, Angela; Venturelli, Francesco; Borella, Paola
abstract
Introduction: When breast feeding is not possible, infant formulas are often used as substitutes for human milk and play an indispensable role in infant nutrition. These substitutes are specially manufactured and fortified with micronutrients such as vitamin, trace and mineral elements, essential to satisfy the nutritional requirements of infant. Although trace elements play an important role in infants’ growth and development, their amount in formula composition has received very little attention, since recent research on such food has focused mainly on protein and energy content. We aimed to determine the levels of various essential (Fe, Zn, Cu, Mn, Se, Cr) and toxic (Cd, Pb) elements in a representative sample of infant starting (0-6 months) formulas consumed in Italy, in order to increase the knowledge on infant exposure to trace elements and to compare the results with standard recommended values. Formula milk concentrations of the investigated elements were also compared with those obtained in a sample of mother’s milk.
Materials and methods: The mineral content of the commercially available milk-based infant formulas consumed in Italy together with 5 human milk samples were investigated. We included starting infant cow’s milk, powder and liquid formulas and we excluded products not officially on sale in Italy. Dry powder milk samples were reconstituted according to the manufacturer's instructions, using distilled water to avoid any external contamination. The levels of elements were determined by ICP-MS after microwave digestion. For the precision and accuracy of the method, a standard reference material (BCR 063R: whole milk powder) was analyzed.
Results: The levels of essential elements were within min/max of recommended values established by European directives. Fe, Zn and Mn were significantly higher in all investigated formulas than in breast milk. Particularly, concentrations of Mn from formula varied from 15 up to 40 times the concentration of breast milk. Concentrations of Pb and Cd were detected in some infant formulas, although none in amounts that could represent a health hazard for the consumer, while they were not detected in human milk.
Conclusion: The results of this study highlight two important aspects: the presence in infants formulas, although at low levels, of toxic elements such as lead and cadmium, which in our opinion should be absent in food products, and the excessive fortification of essential elements such as Fe, Zn, Mn in infant formulas in comparison to breast milk. Growing evidence of negative effects on cognitive development from excessive Fe and Mn intake suggests, in line with other researchers, a deep consideration on the real need to fortify commercial human-milk substitutes to such high concentrations, since infants are characterized by higher absorption and less effective excretion of dietary elements compared to adults
2014
- Etiology, source and prevention of waterborne healthcare-associated infections: a review.
[Articolo su rivista]
Ferranti, Greta; Marchesi, Isabella; Favale, Marcella; Borella, Paola; Bargellini, Annalisa
abstract
The purpose of this review is to discuss the scientific literature on waterborne healthcare-associated infections (HCAI) published from 1990 to 2012. The revision focuses on the aquatic bacteria and describes both outbreaks and single cases in relation to patients characteristics, settings, and contaminated sources. An overview of diagnostic methods and environmental investigations is summarized in order to provide guidance for future case investigations. Lastly, on the basis of prevention and control measures adopted, information and recommendations are given. A total of 125 reports were included, 41 of them describing hospitalized children. All cases were sustained by opportunistic pathogens, mainly Legionellaceae, Pseudomonadaceae and Burkholderiaceae. Hot water distribution systems were the primary source of Legionnaires' disease, bottled water was mainly colonized by Pseudomonaceae, and Burkholderiaceae were the leading cause of distilled and sterile water contamination. Intensive care unit was the most frequently involved setting but patient characteristics are the main risk factor, independently of the ward. As the microbes water contamination is difficult to be avoided and disinfection treatments may be insufficient to control the risk of infection, a proactive preventive plan should be put in place. Nursing staff should pay special attention to children and immunosuppressed patients to avoid tap water exposure, also for their personal hygiene, and to regularly use sterile water for rinsing/cleaning devices
2014
- Hand Hygiene Knowledge, Hand Contamination and Practice of Italian Nursing and Medical Students
[Articolo su rivista]
Bargellini, Annalisa; Ferranti, Greta; Santangelo, Maddalena; Venturelli, Francesco; Borella, Paola; Marchesi, Isabella
abstract
Background: Our objective was to measure hand bacterial contamination in a group of Italian nursing and medical students attending clinical wards for practical training, in order to verify the reliability of the information on hand hygiene (HH) adherence obtained by a self-reporting questionnaire. This questionnaire was administered with the aim of exploring the effectiveness of basic education.
Methods: In this cross-sectional study, an anonymous questionnaire designed to investigate HH knowledge and practices was administered to a convenience sample of 100 nursing and 100 medical students. Data collected was combined with hand bacterial contamination measured both at the point of entry and exit from the ward.
Results: HH practices and knowledge were significantly higher in nursing compared to medical students. The most effective procedure in reducing bacterial contamination was the alternate use of hand washing and hand rubbing compared to only one practice and the absence of hand hygiene (geom. mean: 180.3, 410.2 and 907.4 CFU/hand respectively, p<0.001).
Hand contamination was significantly higher in students who declared to have hardly ever/never implemented HH teaching during clinical practice compared to those who stated to have done it frequently/always (geom. mean: 716 vs 277.1 CFU/hand, p<0.02).
ConclusionS: Our investigation adds something new to the topic of HH that is the measure of bacterial hand contamination to verify the reliability of the information obtained by questionnaire. The findings, pointing out some critical aspects in HH teaching among healthcare students, highlight that solid knowledge results in correct behaviour, and consequently in a reduction of hand contamination.
2014
- Legionella spp. survival after different disinfection procedures: Comparison between conventional culture, qPCR and EMA–-qPCR
[Articolo su rivista]
A., Mansi; I., Amori; Marchesi, Isabella; A. M., Marcelloni; A. R., Proietto; Ferranti, Greta; V., Magini; F., Valeriani; Borella, Paola
abstract
The development of rapid and sensitive methods for the detection and quantification of Legionella viable cells is essential for monitoring water quality and preventing legionellosis. The aim of this study was to verify the
applicability of a quantitative PCR (qPCR) method used in combination with ethidium monoazide (EMA) to the quantification of Legionella spp. in samples collected from swimming pools, water recirculation systems and hot water
systems in two fitness clubs. This molecular technique (EMA–-qPCR) allows the amplification of target DNA from culturable and viable cells, but prevents the amplification of DNA from non-viable cells. The effectiveness of this
new method able to detect alive legionellae was also compared with conventional qPCR and culture method. Our results confirm that EMA–-qPCR allows to discriminate the non-viable cells from those viable and that it is
particularly indicated for monitoring the effectiveness of thermal treatments for the Legionella contamination control in water environments, also providing information about the presence of Viable But Non-Culturable (VBNC) cells.
Other Gram-negative bacteria typically associated with biofilm were identified in samples taken from swimming pools and balance tanks, suggesting that also the presence of biofilm should be monitored for a more general
view of water contamination.
2014
- Ruolo dell’igienista nella sorveglianza e nel controllo dei casi sospetti di Ebola: un esempio di integrazione ospedale-territorio nella Provincia di Modena
[Relazione in Atti di Convegno]
Bellucci, C; Bottosso, E; Filippini, T; Santangelo, M; Soncini, F; Venturelli, F; Borella, P
abstract
Il Virus Ebola è un Filovirus responsabile di una grave forma di Febbre Emorragica con un tasso di letalità compreso tra il 50 e il 90%. Non esistono attualmente terapie approvate per uso umano al di fuori del trattamento di supporto: sono in fase di sviluppo differenti strategie terapeutiche fra cui vaccini, molecole interferenti con la produzione di proteine virali e anticorpi monoclonali. Da 9 mesi è in corso in Africa Occidentale nei territori di Nigeria, Sierra Leone, Guinea e Liberia la più grave ed estesa epidemia di Ebola registrata dalla scoperta del virus con più di 3000 casi fra confermati e sospetti ed oltre 1500 decessi. In ragione di ciò l’OMS ha dichiarato tale epidemia “un’emergenza di Sanità Pubblica di rilevanza internazionale” ed ha emanato specifiche raccomandazioni per i paesi direttamente colpiti e per gli Stati membri. La Regione Emilia Romagna, in accordo con le indicazioni del Ministero della Salute, ha emanato una specifica circolare sulla base della quale l’Ausl di Modena ha predisposto un piano condiviso con l’AOU Policlinico allo scopo di individuare e gestire prontamente i casi sospetti. L’agente infettivo viene trasmesso per contatto diretto di mucose o cute non integra coi fluidi corporei e secrezioni di persone e animali infetti. Dopo un periodo di incubazione variabile tra 2 e 21 giorni, i primi sintomi di malattia sono aspecifici (febbre, malessere generale, cefalea, mialgie) mentre col progredire dell’infezione si può assistere ad un’evoluzione verso l’insufficienza multi-organo o forme francamente emorragiche. Sono state formalizzate istruzioni operative per la gestione protetta del caso sospetto, dall’accettazione, alla diagnosi, fino al trasferimento presso i centri di riferimento nazionali (Spallanzani-Roma, Sacco-Milano), resi fruibili dispositivi di protezione individuali per gli operatori e informato il personale sanitario dei percorsi strutturati mediante adeguati corsi di formazione. A livello locale, le Direzioni Sanitarie dovranno promuovere l’integrazione delle attività di comunicazione tra le diverse strutture coinvolte (ospedali, distretti, Dipartimenti di Sanità Pubblica, Dipartimenti delle Cure Primarie, Servizi di Continuità Assistenziale) con i medici di medicina generale e i pediatri di libera scelta, per garantire un’informazione corretta sulla malattia, sui rischi e sulle misure di prevenzione e per contribuire ad evitare immotivati allarmismi, facendo riferimento a quanto pubblicato e costantemente aggiornato sul sito del Ministero della Salute.
2014
- Selenium neurotoxicity in humans: Bridging laboratory and epidemiologic studies.
[Articolo su rivista]
Vinceti, Marco; Mandrioli, Jessica; Borella, Paola; Michalke, B; Tsatsakis, A; Finkelstein, Y.
abstract
Selenium is a metalloid of considerable interest in the human from both a toxicological and a nutritional perspective, with a very narrow safe range of intake. Acute selenium intoxication is followed by adverse effects on the nervous system with special clinical relevance, while the neurotoxicity of long-term overexposure is less characterized and recognized. We aimed to address this issue from a public health perspective, focusing on both laboratory studies and the few epidemiologic human studies available, with emphasis on their methodological strengths and limitations. The frequently overlooked differences in toxicity and biological activity of selenium compounds are also outlined. In addition to lethargy, dizziness, motor weakness and paresthesias, an excess risk of amyotrophic lateral sclerosis is the effect on the nervous system which has been more consistently associated with chronic low-level selenium overexposure, particularly to its inorganic compounds. Additional research efforts are needed to better elucidate the neurotoxic effects exerted by selenium overexposure.
2014
- Valutazione dei rischi di malattia da agenti biologici, fisici e chimici nell'era della globalizzazione: dati epidemiologici e strategie di prevenzione
[Relazione in Atti di Convegno]
Borella, Paola; Ferranti, Greta; Aggazzotti, Gabriella; Marchesi, Isabella; Bargellini, Annalisa
abstract
In questa pubblicazione vengono riportati alcuni dei più attuali contaminanti chimico-fisici e infettivi che attraverso la catena alimentare possono rappresentare un rischio per la salute umana
2013
- A culture-proven case of community-acquired Legionella pneumonia apparently classified as nosocomial: diagnostic and public health implications
[Articolo su rivista]
Bargellini, Annalisa; Marchesi, Isabella; P., Marchegiano; Richeldi, Luca; R., Cagarelli; Ferranti, Greta; Borella, Paola
abstract
We report a case of Legionella pneumonia in a 78-year-old patient affected by cerebellar haemangioblastoma continuously hospitalised for 24 days prior to the onset of overt symptoms. According to the established case definition, this woman should have been definitely classified as a nosocomial case (patient spending all of the ten days in hospital before onset of symptoms). Water samples from the Oncology ward were negative, notably the patient’s room and the oxygen bubbler, and the revision of the history-case induced us to verify possible contamination in water samples collected at home. We found that the clinical strain had identical rep-PCR fingerprint of L. pneumophila serogroup 1 isolated at home.
The description of this culture-proven case of Legionnaires’ disease has major clinical, legal and public health consequences as the complexity of hospitalised patients poses limitations to the rule-of-thumb surveillance definition of nosocomial pneumonia based on 2-10 days incubation period
2013
- APPROFONDIMENTO SUI FATTORI DI
RISCHIO PER LA POLMONITE DA LEGIONELLA SPP:
REVISIONE DEI CASI NOTIFICATI IN REGIONE
EMILIA-ROMAGNA
[Abstract in Rivista]
F., Baldoni; C., Gualanduzzi; A. C., Finarelli; Bargellini, Annalisa; Borella, Paola; R., Cagarelli; Santangelo, Maddalena
abstract
OBIETTIVI: La polmonite da Legionella spp è associata
alla presenza di diversi fattori di rischio, in particolare malattie
cronico degenerative, fumo di sigaretta, assunzione di
alcool e droghe, e in generale con fenomeni di immunodepressione.
I dati ufficiali delle notifiche riportano tuttavia
una percentuale di circa il 50% di persone che ammalano in
assenza di co-morbilità. Scopo dello studio è revisionare le
schede di sorveglianza per la legionellosi per verificare se la
mancata segnalazione di fattori di rischio sia un fenomeno
reale o legato a carenze nella compilazione della scheda e/o
a errata diagnosi.
METO DI: Lo studio, condotto con metodologia casocontrollo,
prevede di revisionare le schede di sorveglianza
per la legionellosi pervenute alla Regione Emilia Romagna
nel triennio 2009-2011. La prima fase riguarda una attenta
rilettura delle schede per estrapolare quelle in cui non vengono segnalati fattori di rischio noti in grado di spiegare
la malattia (“casi”). Successivamente ad ogni caso viene
associato un paziente con polmonite da Legionella portatore
di fattori di rischio noti estratto casualmente dall’intera lista
(“controllo”). RISULTATI: Lo studio è in corso e si concluderà nel mese di settembre. Da una prima indagine è emerso che
oltre il 20% delle schede raccolte negli anni presi in considerazione riguardano soggetti apparentemente privi di fattori associabili all’insorgenza della malattia. Il medico di famiglia ed i sanitari che hanno avuto in cura il paziente nel periodo della polmonite vengono contattati per completare la scheda. Particolare attenzione viene data alle indagini laboratoristiche svolte per stabilire l’origine della polmonite (antigene urinario, metodo colturale, sierologia ecc.) oltre all’indagine anamnestica successiva alla polmonite per comprendere se siano comparsi sintomi di malattie cronico-degenerative non riscontrabili al momento dell’evento.
CONCLUSIONI: I risultati di questa indagine possono
rivestire particolare interesse per la mancanza di informazioni
scientifiche sulle caratteristiche dei soggetti malati di legionellosi, ma apparentemente privi di fattori di rischio associati ad infezioni da opportunisti. In particolare, lo studio intende distinguere se al momento dell’esordio non fossero presenti malattie immunodepressive comparse solo dopo l’evento oppure se sia opportuno consigliare maggiore attenzione nella compilazione delle schede e nella attribuzione al germe legionella della polmonite in relazione al tipo di indagine laboratoristica utilizzata.
2013
- LEGIONELLA SPP SURVIVAL AFTER DIFFERENT DISINFECTION PROCEDURES: COMPARISON BETWEEN CONVENTIONAL CULTURE AND EMA-QPCR
[Abstract in Rivista]
A., Mansi; I., Amori; Marchesi, Isabella; A. M., Marcelloni; A. R., Proietto; Ferranti, Greta; Bargellini, Annalisa; V., Magini; F., Valeriani; Borella, Paola
abstract
Quantitative real-time-PCR (q-PCR) is largely used to evaluate different pathogens in both environmental and clinical samples, including Legionella spp Advantages on traditional culture include the high sensitivity, accuracy and rapid evaluation of germ contamination. The main disadvantage is that this method does not distinguish dead/viable cells, a relevant aspect in case of continuous disinfection like in swimming pools. This study presents a new quantitative PCR method using ethidium monoazide (EMA) to detect only viable cells. The comparison with conventional culture can further inform on culturable and VBNC (viable but not culturable) Legionella spp. To develop the new test, experiments have been conducted with L. pneumophila ATCC 33152. We compared EMA addition at different concentrations on both viable cells during exponential growth period and dead cells. After DNA extraction, q-PCR reaction was made using LightMix kit Legionella spp with amplification of the fragment 386 bp of 16S gene. Water samples from swimming pools and hot water distribution systems treated with both chlorine and other disinfection procedures have been collected for analysis by EMA-qPCR. All samples have been also analysed with conventional culture (ISO-11731) to isolate Legionella spp. EMA in the range 100-6 μM was able to completely inhibit DNA amplification in samples containing dead legionellae at concentration of 3x105 UFC/L. In contrast, EMA at concentrations of 6 μM did not reduce the q-PCR results on viable Legionella. However, higher EMA levels were associated with partial inhibition of DNA amplification on viable cells due to dye toxicity. The analyses on real water samples are still in course. Our results confirm that the Ema-qPCR can represent a new procedure able to distinguish dead and viable legionellae. We underline the need for a balance between EMA toxicity and efficacy, depending on Legionella spp concentration. The results of this method on water samples collected from both swimming pools and hot water distribution systems will be useful to compare EMA-qPCR and culture in evaluating differences in dead/viable/culturable germ cells according to various disinfection procedures.
2013
- Legionella e Pseudomonas spp, i maggiori determinanti
di infezioni di origine idrica in ospedale: differenze nella
contaminazione e nella risposta ai sistemi di disinfezione
[Articolo su rivista]
Borella, Paola; Marchesi, Isabella; P., Marchegiano; Ferranti, Greta; Santangelo, Maddalena; A., Campagna; Bargellini, Annalisa
abstract
In this study, long-term surveillance of Legionella and Pseudomonas spp contamination in water systems of
a big hospital and effi cacy of disinfection treatments are reported. In the period 2008-2011, 550 hot water
samples from technical rooms and showers/taps of hospital wards were collected for Legionella and Pseudomonas
spp isolation by cultural methods. In the hospital, several measures to control water contamination,
including shock treatments and continuous systems (chlorine dioxide, monochloramine, boiler) have been
employed. Legionella spp was detected in 38.9% of the samples, and the more effective methods in reducing
contamination were in order boiler, monochloramine and chlorine dioxide. Pseudomonas spp was isolated
in 25.4% of the samples, mainly at peripheral sites; the number of positive sites were reduced effi ciently by
boiler, while the other methods did not signifi cantly modify the contamination. Different associations between
the two studied bacteria and some water parameters, such as total bacterial count, pH and metals, were
observed. Our study points out that Legionella and Pseudomonas spp differ for contamination mode and
for response to disinfection systems. The prevalent contamination of pseudomonas at point-of-use suggests
that, besides disinfection, the constant maintenance and replacement of faucets and showers is mandatory
to control this germ.
2013
- Legionellosis risk in swimming pool and SPA
[Abstract in Rivista]
Ferranti, Greta; Bargellini, Annalisa; Marchesi, Isabella; A., Mansi; Borella, Paola
abstract
Spas used for either therapeutic or recreational aims are considered at risk for legionellosis occurrence. Thermal water is normally used at temperature between 30 and 40°C, ideal for Legionella growth, with a potential risk for users. Inhalation of colonized aerosol has been associated with sporadic cases or clusters of both Legionnaires’ disease and Pontiac fever, particularly involving immune depressed subjects. Italian and European guidelines have been issued to prevent and control this risk. At the spring, thermal water can contain small concentrations of legionellae, but within the distribution lines the amplification of these bacteria is promoted by stagnancy and incrustation, a frequent phenomenon also associated with the high mineral content of these waters. In addition, the detachment of dead cells, body lotions/creams residuals and skin debris in swimming pools favorites the bacteria multiplication. The devices/treatments more involved in transmission risk are inhalation therapies, frequently utilized by persons with chronic disease, showers and whirlpools, largely used also in the wellness centers. We revised the studies on Legionella spp presence in hot springs and related structures. The majority of published reports documented the germ contamination both at the source and along the distribution lines up to the point of use with increasing concentrations. Particular water characteristics such as high levels of sulfur and/or carbonate seem to be unfavorable to legionellae colonization but further studies are needed to deep this aspect. Contamination risk is less relevant for swimming pools due to high chlorine content, unless an insufficient disinfection plan is applied. From eighty years, about 50 studies have been published documenting cases of Legionnaires’ disease associated with spas. The majority of them occurred in Japan, where also a large outbreak is described with more than 300 persons involved. In almost all cases, L. pneumophila was the responsible germ and during the environmental inquire Legionella spp was found in many points of the spas: in spring water, in the distribution system, in the tank, in devices for nasal irrigation and aerosol therapy as well as in the whirlpool bath and swimming pool. To study the infection risk, the antibodies against Legionella have been evaluated in workers and patients attending the spa; the antibodies presence was found in a decreasing proportion from therapists to administration personnel. In conclusion, we underline the need for an accurate surveillance and control of Legionella spp and other waterborne germs in spas and other structures where inhalation of aerosolized water is expected.
2013
- Monochloramine and chlorine dioxide for controlling Legionella pneumophila contamination: biocide levels and disinfection by-products (DBPs) formation in hospital water networks.
[Articolo su rivista]
Marchesi, Isabella; Ferranti, Greta; Bargellini, Annalisa; Marchegiano, Patrizia; Predieri, Guerrino; Stout, Je; Borella, Paola
abstract
Legionella colonization in hospital hot water distribution networks was evaluated
following 36 months of continuous treatment with monochloramine and compared with
chlorine dioxide. Nitrite, nitrate, chlorite, chlorate, bromide, trihalomethanes and
haloacetic acids as well as the biocide concentration at sampled points were
measured. Only 8/84 samples treated with monochloramine were found contaminated
and after the first 8 months of treatment no Legionella was isolated. Chlorine dioxide
was associated with a strong reduction in Legionella contamination compared to pretreatment,
but differences according to the device were observed. Monochloramine
between 2 and 3 mg l−1 and chlorine dioxide between 0.50 and 0.70 mg l−1 were
needed to control Legionella colonization. Comparing no- and post-flush samples, a
higher frequency of no-flush positive samples was noted using chlorine dioxide,
suggesting an increased risk for patients when they open the tap. No increase in
chlorite levels and no water nitrification occurred by using monochloramine. Chlorite at
levels exceeding the limit requested for drinking water was measured when chlorine
dioxide was applied. In conclusion, we highlight that continuous injection of
monochloramine should be considered as an effective alternative to chlorine dioxide in
controlling legionellae contamination inside hospital water distribution systems
2013
- Selenium and human health: bridging together epidemiological and laboratory evidence.
[Abstract in Atti di Convegno]
Vinceti, Marco; Bargellini, Annalisa; Malagoli, Carlotta; Borella, Paola
abstract
.
2013
- Utilizzo della metodica EMA-qPCR per la stima delle cellule vitali di Legionella spp.
[Abstract in Rivista]
A., Mansi; I., Amori; A. R., Proietto; A. M., Marcelloni; R., Giugliano; Marchesi, Isabella; Borella, Paola
abstract
OBIETTIVI: La PCR quantitativa (qPCR) è una metodica utilizzata da tempo per la stima di patogeni in campioni ambientali e clinici. Nonostante offra diversi vantaggi rispetto ai metodi tradizionali colturali, il principale ostacolo per una maggiore diffusione del metodo è rappresentato dalla mancanza di informazioni circa la vitalità o meno delle cellule microbiche. Il presente studio ha verificato l’applicabilità in laboratorio di un nuovo metodo quantitativo (EMA-qPCR) per distinguere le cellule morte di Legionella spp da quelle vitali mediante l’uso di bromuro di etidio monoazide (EMA). Questo colorante entra selettivamente nelle cellule con membrana
danneggiata intercalandosi al DNA ed impedendone l’amplificazione. METO DI: Sono stati allestiti saggi sperimentali (L. pneumophila ATCC 33152) in cui legionelle in fase esponenziale di crescita (cellule vive) e legionelle uccise al calore (cellule morte) venivano trattate con EMA a diverse
concentrazioni (1,5-3-6-12,5-50-100 μM) in presenza di luce (500W). Dopo estrazione del DNA, la reazione di qPCR veniva condotta utilizzando il LightMix kit Legionella spp che permette l’amplificazione di un frammento (386 bp) del gene 16S. Le unità genomiche venivano calcolate confrontando le concentrazioni ottenute con quelle di una curva di calibrazione e con legionelle non trattate con EMA. Su tutti i campioni veniva eseguito anche l’esame colturale (ISO-11731) per la ricerca di Legionella spp. RISULTATI : I risultati delle analisi di EMA-qPCR mostrano che l’amplificazione del DNA estratto da 3x105 UFC/L di legionelle uccise veniva completamente inibita con concentrazioni di EMA da 100 a 6 μM. Il trattamento
di un’ analoga concentrazione di legionelle vive con 6 μM di EMA non determinava una riduzione del numero di unità genomiche rispetto a quelle ottenute dalle analisi di qPCR di cellule non trattate con EMA. Concentrazioni di EMA superiori a 6 μM causavano invece inibizione parziale o totale dell’amplificazione del DNA delle cellule vitali a causa della tossicità del colorante. CONCLUSIONI: I nostri dati dimostrano che l’utilizzo del bromuro di etidio monoazide (EMA) in combinazione con la qPCR è un metodo in grado di distinguere la presenza di legionelle vive da quelle morte. Questi risultati indicano che la scelta della concentrazione di EMA deve tener conto della tossicità del colorante. Ulteriori
indagini sono in corso per verificare quanto colorante sia necessario in funzione della concentrazione di Legionella
spp nel campione ambientale.
2012
- Conoscenze sulla tubercolosi e percezione del rischio tra i giovani universitari, Modena-2011
[Articolo su rivista]
Morandi, Matteo; Favale, Marcella; Borsari, Lucia; Carluccio, Eugenia; Bisaccia, Eufemia; Arcolin, Elisa; Baldoni, Filippo; Bargellini, Annalisa; Borella, Paola; Bergomi, Margherita; Aggazzotti, Gabriella
abstract
In November 2011, a cross-sectional study was carried out among 824 first-year university students from medical andnon-medical school sectors about knowledge on infection and tuberculosis characteristics, risk factors and prevention. Medicalsector students were founded with higher general knowledge level (OR 1.61, IC 95%: 1.43-1.79), but both groups showed littleknowledge of risk factors and low level of risk perception. Radio and television were indicated as main source of information.
2012
- Control of Legionella contamination in a hospital water distribution system by monochloramine
[Articolo su rivista]
Marchesi, Isabella; S., Cencetti; P., Marchegiano; Frezza, Giuseppina; Borella, Paola; Bargellini, Annalisa
abstract
Background: We report the results of 1-year application of monochloramine to control Legionella pneumophila contamination in a hospital hot water distribution system. Methods: In the main building of the hospital, a device continuously distributing monochloramine was installed. Legionella pneumophila and Pseudomonas spp contamination was followed in comparison with 2 other water networks in the same building using chlorine dioxide. Results: Monochloramine significantly reduced the number of contaminated sites compared with baseline (from 97.0% to 13.3%, respectively), chlorine dioxide device I (from 100% to 56.7%, respectively), and device II (from 100% to 60.8%, respectively). No positive sample exceeded 104 colony-forming units/L versus 59.4% at baseline. Conclusion: Monochloramine could represent a good alternative to chlorine dioxide in controlling legionellae contamination in public and private buildings.
2012
- Hand hygiene in nursing and medical students during training: a study on knowledge, practices and impact on bacterial contamination.
[Abstract in Rivista]
Bargellini, Annalisa; Marchesi, Isabella; Ferranti, Greta; Favale, Marcella; Borella, Paola
abstract
Aim. To collect information about knowledge, behavior and hand hygiene (HH) practices in Italian nursing and medical students combining data with hand bacterial contamination before and after a morning training. Methods. A questionnaire designed to investigate knowledge on HH and its practical realization was administered to a casual sample of 100 nursing and 100 medical students attending our University. Data collected were associated with hand contamination measured at the entrance and exit of the turn of training. Results. All nursing students performed HH during training and the frequency was significantly higher compared to medical students, 39% of which declared not to have done it. At the end of training, hand contamination were significantly reduced in both groups, but more pronounced in nursing students. Scores on the HH knowledge were significantly related to HH practices and self-reported HH compliance and were significantly higher for nursing students. Students were also asked to give their opinion on HH knowledge acquired during the course and a significant increase of adequacy as the medical students progressed through their course was found. Discussion. Since the first year of their course, nursing students receive adequate knowledge and consequently apply HH practices during training activities, data confirmed by total bacterial count. Medical students get HH knowledge later and less attention is devoted to these practices also in relation to the reduced occasions of patient contact during their training. This suggested us to anticipate the Hygiene and Public Health teaching before the start of the training activity.
2012
- Igiene delle mani in studenti di Infermieristica e Medicina durante i tirocini: studio pilota su conoscenze, comportamenti e impatto sulla contaminazione batterica
[Articolo su rivista]
Bargellini, Annalisa; Borella, Paola; Ferri, Paola; Ferranti, Greta; Marchesi, Isabella
abstract
Introduction. Despite exhaustive guidelines on hand hygiene (HH), compliance in health care professionals is reported to be low. In order to improve adherence with HH, interventions on students’ education should be effective. Aim. To describe the knowledge, behavior and hand hygiene (HH) practices in nursing and medical students. The results of the pilot study are presented.
Methods. A questionnaire designed to investigate knowledge on HH and its practical implementation was administered to a sample of 50 nursing and 50 medical students. Data collected were associated with hand contamination measured at the beginning and at the end of the training shift. Results. All nursing students performed HH with a significantly higher frequency compared to medical students. At the end of training, total bacterial counts were significantly reduced in both groups, but more in nursing students. Total bacterial count increased in absence of hygienic practices and the most effective procedure was the alternate use
of conventional hand washing and alcohol-based hands rubs.
The knowledge of both groups was adequate, although some
differences were observed. Conclusions. At the beginning of their course, nursing students are educated to correct practices that implement during practical training. Medical students receive information on HH later in their education and pay less attention to these aspects, also due to the limited number of physical contacts with patients. Thus, the contents on HH should be anticipated before the start of the training activity.
2012
- Water contamination
[Capitolo/Saggio]
Borella, Paola; Marchesi, Isabella; A., Mansi; Favale, Marcella; Bargellini, Annalisa
abstract
In this current book, the authors have called attention to the issue of hospital infection control. They focus on basic learning and clinical guidelines in the ongoing effort for optimal control. The information provided will be helpful in reducing the burden of health-care associated infections.
2011
- Comparison of procedures for controlling hot waterLegionella pneumophila contamination in health structuresP. Borella, I. Marchesi, P. Marchegiano, A. Bargellini, G. Ferranti,S. Cencetti
[Abstract in Rivista]
Borella, Paola; Marchesi, Isabella; P., Marchegiano; Bargellini, Annalisa; G., Ferranti; S., Cencetti
abstract
In a big hospital of northern Italy colonized by L. pneumophila, the effectiveness of various procedures in controlling contamination and preventing case onset was evaluated. Application of superheating showed the lest capability in reducing Legionella and is not suitable for large buildings as flushing with water >60°C at each outlet cannot reliably be maintained. In emerging situations, shock hyperchlorination is preferable as a more effective germ reduction method although requires higher manpower and pipes corrosion cannot be excluded. Point-of-care filters achieve the goal of 100% negative samples, and are adopted where transplant, oncological and other high risk patients are hospitalized. Also electric boilers installed on cold water line in high risk patient rooms guarantee absence of contamination, provided that temperature is maintained above 58°C. Continuoustreatment with chlorine dioxide is highly efficient in reducing germ concentration, but does not eradicate Legionella from the system, and at least 0.3 ppm at outlets are requested for the goal of L. pneumophila concentration below 100 cfu/L. More satisfactoryresults were obtained by injecting monochloramine, as control of contamination was evident just within the first month of application. Monochloramine level associated with germ below the detection limit approximate 3 ppm, but 2 ppm were sufficient for reducing legionellae below 100 cfu/L. Application of different procedures according to patient risk appear to be the best strategy and no cases of nosocomial Legionnaires’ disease were detected in the hospital during the observation period.
2011
- Ecological behaviour of three serogroups of Legionella pneumophila within a model plumbing system
[Articolo su rivista]
Messi, Patrizia; Anacarso, Immacolata; Bargellini, Annalisa; Bondi, Moreno; Marchesi, Isabella; DE NIEDERHAUSERN, Simona; Borella, Paola
abstract
Three Legionella pneumophila strains isolated from water samples and belonging to serogroups (sgs) 1, 6, and 9 were analysed for their capability to colonise an experimental model simulating a domestic hot water distribution system. Ecological factors that could influence the persistence of sgs as intracellular life within protozoan hosts and bacterial interference by the production of antagonistic compounds were also studied. L. pneumophila viable counts incremented both in the planktonic and in the sessile phases. Serogroup 6 had a marked prevalence during the whole experiment and exhibited the highest host infection efficiency. Serogroup 1 was significantly less represented, but showed the highest capability to reproduce inside the protozoan hosts. Serogroup 9 was poorly isolated and less adapted to the intracellular life. Among 14 bacteria continuously isolated in the system, five (35.7%) produced antagonistic substances against legionella, with differences according to the bacterial strain and L. pneumophila serogroups.
2011
- Effectiveness of different methods to control legionella in the water supply: ten-year experience in an Italian university hospital.
[Articolo su rivista]
Marchesi, Isabella; Marchegiano, P; Bargellini, Annalisa; Cencetti, S; Frezza, Giuseppina; Miselli, M; Borella, Paola
abstract
We report our ten-year experience of hyperchlorination, thermal shock, chlorine dioxide, monochloramine, boilers and point-of-use filters for controlling legionella contamination in a hospital hot water distribution system. Shock disinfections were associated with a return to pre-treatment contamination levels within one or two months. We found that chlorine dioxide successfully maintained levels at <100cfu/L, whilst preliminary experiments gave satisfactory results with monochloramine. No contamination was observed applying point-of-use filters and electric boilers at temperatures of >58°C and no cases of nosocomial legionellosis were detected in the ten-year observation period. Our performance ranking in reducing legionella contamination was filter, boiler, chlorine dioxide, hyperchlorination and thermal shock. Chlorine dioxide was the least expensive procedure followed by thermal shock, hyperchlorination, boiler and filter. We suggest adopting chlorine dioxide and electric boilers in parallel.
2011
- Hand hygiene in students of medical school during training activities: knowledge, behaviour and prevalence of bacterial contamination.
[Abstract in Rivista]
Borella, Paola; Marchesi, Isabella; Bargellini, Annalisa; Ferri, Paola; Aggazzotti, Gabriella; S., Cencetti
abstract
The aim of the study was to evaluate knowledge, attitude and on-field practices concerning hand hygiene of undergraduate students attending the university hospital of Modena. The prevalence of bacterial contamination of their hands at entry to ward and at exit was also evaluated. Swab samples were analysed for total bacteria count at 37°C, Staphylococcus aureus, Pseudomonas aeruginosa and enterococci. At the end of the morning activity, participant students filled a questionnaire on personal data, activities, opportunities, opinion and compliance of hand hygiene. Higher total counts were measured at entrance compared to exit in both medical and nursing students, but the last group exhibited a stronger reduction due to higher compliance with hand-hygiene practices. Alcohol gel was the preferred procedure, and showed also a higher efficacy in reducing hand contamination. Contacts with stethoscopes and case history were those associated with higher levels of total bacterial counts as no hand hygiene followed those activities. No pathogen was recovered with the exception of two samples colonised by Staphylococcus aureus. Knowledge on hand hygiene was in general good, but should be implemented for students becoming doctors.
2011
- Igiene e sanità pubblica
[Capitolo/Saggio]
Aggazzotti, Gabriella; Borella, Paola
abstract
Gli autori illustrano ed approfondiscono i principali sviluppi e cambiamenti della disciplina Igiene/sanità pubblica avvenuti negli ultimi 60 anni presso l'Università di Modena e Reggio Emilia
2011
- Parameters predictive of Legionella contamination in hot water systems: association with trace elements and heterotrophic plate counts
[Articolo su rivista]
Bargellini, Annalisa; Marchesi, Isabella; Righi, Elena; Ferrari, Angela; S., Cencetti; Borella, Paola; Rovesti, Sergio
abstract
The contamination of hot water samples with Legionella spp. was studied in relation to temperature, total hardness, trace element concentrations (iron, zinc, manganese, and copper) and heterotrophic plate counts (HPC) at both 22 and 37 °C. Factor analysis and receiver operating characteristic (ROC) curves were used to establish the cut-off of water parameters as predictors for Legionella contamination. Legionella spp. were isolated in 194 out of 408 samples (47.5%), with L. pneumophila being the most common (92.8%). After multiple logistic regression analysis, the risk for legionellae colonisation was positively associated with Mn levels >6 µg l-1, HPC at 22 °C >27 CFU l-1, and negatively with temperature >55 °C and Cu levels >50 µg l-1. Multiple regression analysis revealed that Legionella spp. counts were positively associated with Mn, HPC at 37 °C and Zn and negatively associated with temperature. Only 1 out of the 97 samples (1%) having a Mn concentration, an HPC at 22 °C and an HPC at 37 °C below the respective median values exhibited a Legionella spp. concentration exceeding 104 CFU l-1 vs. 41 out of the 89 samples (46.1%) with the three parameters above the medians. Our results show a qualitative and quantitative relationship between Legionella spp., the Mn concentration and heterotrophic plate counts in hot water samples from different buildings, suggesting that these parameters should be included in a water safety plan. The role of manganese in biofilm formation and its possible involvement in the mechanisms favouring Legionella survival and growth in water niches should be investigated further.
2011
- Pratiche di igiene delle mani in studenti di medicina e infermieristica: conoscenze, adesione ed impatto sulla contaminazione batterica
[Abstract in Rivista]
Bargellini, Annalisa; Marchesi, Isabella; Favale, Marcella; G., Ferranti; Ferri, Paola; Borella, Paola
abstract
Scopo dello studio è quello di valutare conoscenze, atteggiamenti e pratica sul campo inerenti l’igiene delle mani fra gli studenti di medicina e gli allievi infermieri che svolgono attività di tirocinio presso l’ospedale universitario di Modena. I dati raccolti sono stati associati al livello di contaminazione batterica delle loro mani misurata all’entrata e all’uscita dal reparto. A tal scopo sono stati valutati: carica batterica totale a 37°C, Staphylococcus aureus, Pseudomonas aeruginosa ed enterobatteri. A fine attività, gli studenti coinvolti nello studio hanno compilato un questionario su dati personali, attività, opinioni e compliance al lavaggio delle mani. È stata rilevata una carica batterica totale più elevata all’ingresso rispetto all’uscita dal reparto, sia tra gli studenti di medicina che tra gli allievi infermieri, ma in quest’ultimo gruppo si è osservata una riduzione più rilevante associata ad una maggiore frequenza nella pratica del lavaggio delle mani comeconseguenza di più numerose opportunità. La modalità preferita era l’utilizzo dell’alcool gel messo a disposizione in tutto l’ospedale, e questa modalità si è dimostrata più efficace dell’acqua e sapone nel ridurre la contaminazione delle mani, anche se la più bassa carica batterica totale si registrava tra coloro che avevano utilizzato entrambi i metodi, eventualmente associati all’uso dei guanti. Alcune pratiche come il contatto con il fonendoscopio e le cartelle cliniche erano associate ad un incremento della contaminazione perché queste azioni non erano seguite dal lavaggio delle mani. Non sono stati rilevati batteri patogeni ad eccezione di due campioni colonizzati da Staphylococcus aureus. Le conoscenze sull’igiene delle mani e la corretta applicazione da parte dei tirocinanti può considerarsi buona anche se occorrerebbe una maggiore attenzione verso talepratica all’ingresso nel reparto.
2010
- Elementi in traccia e carica batterica totale come parametri predittivi della contaminazione e crescita di Legionella spp. nell’acqua calda sanitaria.
[Abstract in Rivista]
Bargellini, Annalisa; Marchesi, Isabella; Rovesti, Sergio; Frezza, Giuseppina; R., Masironi; Borella, Paola
abstract
Obiettivi. Stabilire la relazione tra parametri chimico-fisici e batteriologici dell’acqua e contaminazione da Legionella spp in campioni di acqua calda prelevati da abitazioni, alberghi e strutture sanitarie. Metodi. Fe, Mn, Cu, Zn, Mg and Ca sono stati analizzati in spettroscopia di assorbimento atomico in 408 campioni prelevati prima di ogni trattamento di disinfezione. Temperatura e durezza sono stati misurati con metodi standard. Per la determinazione di Legionella spp e cariche batteriche totali (CBT) a 37°C e 22°C sono stati utilizzati specifici metodi colturali. Risultati. Legionella è stata isolata da 194 campioni (47,5%) con una carica media di 4.500 ufc/l. I campioni di acqua positivi per Legionella spp mostravano livelli di Fe, Mn, Zn, CBT a 22°C e 37°C significativamente più elevati rispetto ai campioni negativi. La concentrazione di Legionella correlava positivamente con Mn, Fe, Zn e CBT, negativamente con temperatura e durezza dell’acqua. Applicando la regressione lineare multivariata, rimanevano come variabili predittive il Mn, la CBT a 37°C, lo Zn e la temperatura. Applicando invece la regressione logistica multipla, il Mn e la CBT a 22°C risultavano i principali parametri di rischio della presenza di Legionella spp, seguiti da temperatura e rame come fattori di protezione. Conclusioni. In questo studio abbiamo dimostrato che alcuni parametri chimico-fisici e batteriologici dell’acqua sono utili a predire la contaminazione da Legionella spp nell’acqua calda sanitaria. Particolare importanza riveste la misurazione dei livelli di Mn e le cariche batteriche totali, in grado di influire sia sul numero di campioni positivi che sulla concentrazione di legionelle, presumibilmente perché sono indicatori della crescita del biofilm. Si è inoltre confermato che la contaminazione da Legionella si riduce quando la temperatura dell’acqua supera i 55°C.
2010
- Influence of Legionella pneumophila and other water bacteria on the survival and growth of Acanthamoeba polyphaga.
[Articolo su rivista]
Anacarso, Immacolata; E., Guerrieri; Bondi, Moreno; DE NIEDERHAUSERN, Simona; Iseppi, Ramona; Sabia, Carla; Contri, Miranda; Borella, Paola; Messi, Patrizia
abstract
We investigated in solid medium, in water microcosm co-cultures and by light and transmission electron microscopy the influence of Legionella pneumophila Lp-1, Pseudomonas aeruginosa ATCC 27853, Burkholderia cepacia ATCC 25416 and Pseudomonas fluorescens SSD35 on the growth and survival of Acanthamoeba polyphaga. The infection with L. pneumophila was microscopically characterized by the presence of few bacteria inside protozoa at 4th h, and by the beginning of disruptive effects in late phase of trial. In water microcosm studies, performed at different temperature, the more significant interactions were observed at 30°C. In these conditions, L. pneumophila caused a marked reduction in trophozoite and cyst counts from the 4th day until the end of incubation (11 days). B. cepacia showed, by microscopic observation, few and generally single rods within protozoan phagosomes and caused a light reduction of trophozoite viability and cyst formation in co-cultures. A more invasive type of endocytosis, characterized by an early invasion with the presence of a high bacteria number inside amoebae, was observed for Pseudomonas strains. P. fluorescens produced a violent lysis of the host, whereas P. aeruginosa did not cause lysis or suffering. These results underline that water bacteria other than legionella are capable of intracellular survival in Acanthamoeba, influencing the protozoa viable cycle.
2010
- Influence of mineral content on Legionella and bacteria contamination in hot water distribution system
[Abstract in Rivista]
Marchesi, Isabella; Bargellini, Annalisa; A., Mansi; Borella, Paola
abstract
Many minerals largely present in waters are involved in microbial growth, being essential like iron and zinc, or having toxic properties such as copper and manganese. Particular attention has been recently devoted to Legionella spp., an intracellular opportunistic pathogen ubiquitously present in the aquatic environment. L. pneumophila is responsible for severe pneumonia which occurs world-wide in susceptible persons inhaling aerosolised contaminated water. Interestingly, this bacterium is iron-dependent and requires iron superoxide dismutase for viability. In addition, recent studies documented a zinc-metalloprotease, the first identified type II effector necessary for optimal Legionella intracellular infection of amoebae. Copper interacts with hydroperoxide radicals and with the cell membranes, thus it is used as a biocide for controlling water microbial contamination. Lastly, manganese is regarded both as an essential and a toxic component of drinking water, but little is known on its role in bacteria surviving, including legionellae. The aim of this study was to establish the relationship between mineral content of a representative number of hot water samples and microbial contamination with specific reference to Legionella and Pseudomonas spp.
2010
- Inter-laboratory validation of a rapid assay for detection and quantification of Legionella spp. in water samples
[Articolo su rivista]
Bargellini, Annalisa; Marchesi, Isabella; E., Leoni; A., Mansi; S., Cristino; A. M., Marcelloni; Borella, Paola
abstract
Aims: To compare the standard culture method with a new, rapid test (Scan-VIT-Legionella) using fluorescently labelled gene probes for the detection and enumeration of Legionella spp. The new technique was validated through experiments conducted on both artificially and naturally contaminated water and through an inter-laboratory comparison.Methods and Results: All samples were processed by the ScanVIT test according to the manufacturer’s instructions and by a culture method (ISO 11731). ScanVIT detected significantly more positive samples, although concentrations were similar and a strong positive correlation between the two methods was observed (r = 0,888, P < 0,001). The new test was more accurate in identifying the co-presence of Legionella pneumophila and Leg. non-pneumophila. ScanVIT showed a slightly higher Legionella recovery from water samples artificially contaminated with Leg. pneumophila alone or together with Pseudomonas aeruginosa. Lastly, the inter-laboratory comparison revealed that the ScanVIT test exhibits a lower variability than the traditional culture test (mean coefficient of variation 8,7 vs 16,1%).Conclusions: The results confirmed that the ScanVIT largely overlaps the reference method and offers advantages in terms of sensitivity, quantitative reliability and reduced assay time.Significance and Impact of the Study: The proposed method may represent a useful validated alternative to traditional culture for the rapid detection and quantification of Legionella spp. in water.
2010
- Possible protective role of trace elements in human cancer: a review of recent epidemiological studies
[Abstract in Rivista]
Borella, Paola; Bargellini, Annalisa; Marchesi, Isabella; R., Masironi
abstract
The interest in the role of trace elements in cancer is increasing, particularly for those with a possible protective action, such as selenium and zinc. Despite the vast amount of epidemiological studies already conducted, there is a need for further investigations to better understand what compounds, at what levels and with which mechanism trace elements are involved in the protection of a specific cancer or groups of cancer. From our studies, we observed that cancer type and patient characteristics can substantially affect plasma concentrations of trace element status. A better evaluation of the body burden of trace elements should include analysis of other indicators such as hair, cells or tissue specimens, which tends to reflect long-term exposure th these elements.
2009
- EFFICACIA DELLA MONOCLORAMMINA NELLA DISINFEZIONE DI IMPIANTI IDRICI PER IL CONTROLLO DI LEGIONELLA SPP E BIOFILM
[Abstract in Rivista]
Messi, Patrizia; Anacarso, Immacolata; Bargellini, Annalisa; Marchesi, Isabella; Frezza, Giuseppina; Bondi, Moreno; Borella, Paola
abstract
Obiettivi specifici. Data la difficoltà di controllare la contaminazione da Legionella spp in sistemi idrici di grandi edifici, abbiamo ritenuto interessante valutare l’efficacia della monoclorammina, da tempo utilizzata negli USA per la disinfezione dell’acqua condottata, sulla persistenza del germe sia in forma planctonica che sessile in un impianto idrico ospedaliero contaminato da L. pneumophila.Materiali e metodi. Da marzo 2009 è stato installato un impianto a dosaggio controllato (4 mg/l) e continuo di monoclorammina sul sistema di distribuzione dell’acqua calda sanitaria di un edificio ospedaliero. A intervalli di tempo prestabiliti, sia prima che dopo l’installazione dell’impianto, sono stati effettuati prelievi di acqua e biofilm sui quali valutare la contaminazione da Legionella, la carica batterica totale e la presenza di amebe, utilizzando metodiche standardizzate.Risultati. I prelievi effettuati prima dell’utilizzo della monoclorammina hanno evidenziato una forte contaminazione dell’acqua (da 4,5 x 102 a 2,7 x 104 UFC/L secondo i punti di prelievo) con presenza di L. pneumophila sierogruppi 9, 6 e 1. Al termine della prima settimana di trattamento si è ottenuto un miglioramento solo parziale, con il 50% dei punti divenuti negativi; dopo un mese tutti i punti di prelievo, eccetto uno, si sono negativizzati e questo andamento si è confermato successivamente al terzo mese. Per quanto riguarda la carica batterica totale del biofilm, l’andamento è risultato analogo, con una diminuzione da 33.5 a 9,2 UFC/cm2 dopo un mese di trattamento; al termine del terzo mese i valori sono rimasti pressoché costanti (11,8 UFC/cm2). All’interno del biofilm, la concentrazione di legionelle è solo lievemente calata, passando da 4,2 x 102 prima del trattamento a 3,6 x 10 UFC/cm2 dopo tre mesi. La concentrazione di amebe nell’impianto idrico non ha subito variazioni, mantenendosi tra 1 e 10 cellule/ml in circolo e tra 10 e 100 cellule/ml nel biofilm, per tutta la durata della sperimentazione.Conclusioni. Il metodo proposto è risultato efficace nel mantenere sotto controllo la contaminazione da Legionella planctonica nel sistema. Pur essendo la monoclorammina attiva nel ridurre la carica microbica del biofilm, inclusa Legionella, la persistenza di amebe sia nel torrente idrico che nel biofilm sembra comunque favorire la sopravvivenza del patogeno anche in presenza del disinfettante. Sono in corso studi per comparare questo sistema di disinfezione con il biossido di cloro e stabilire se la monoclorammina è più efficace nel ridurre la formazione del biofilm e il rischio di corrosione delle tubature.
2009
- Extremely low frequency-magnetic fields (ELF-EMF) occupational exposure and natural killer activity in peripheral blood lymphocytes
[Articolo su rivista]
Gobba, Fabriziomaria; Bargellini, Annalisa; M., Scaringi; Bravo, Giulia; Borella, Paola
abstract
Extremely Low Frequency-Magnetic Fields (ELF-MF) are possible carcinogens to humans and some data suggest that they can act as promoters or progressors. Since NK cells play a major role in the control of cancer development, an adverse effect on ELF-MF on NK function has been hypothesized. We examined NK activity in 52 workers exposed to different levels of ELF-MF in various activities. Individual exposure was monitored during 3 complete work-shifts using personal dosimeters. Environmental exposure was also monitored. ELF-MF levels in the workers were expressed as Time-Weighted Average (TWA) values. NK activity was measured in peripheral blood lymphocytes (PBL). In the whole group the median occupational TWA was 0.21 microT. According to the TWA levels, workers were classified as low exposed (26 subjects, TWA < or =0.2 microT) and higher exposed workers (26 subjects; TWA >0.2 microT). In higher exposed workers, we observed a trend to reduce NK activity compared to low exposed, but the difference was not significant. Then we selected a subgroup of highest exposed workers (12 subjects; TWA >1 microT); no difference was observed between low and highest exposed subjects in the main personal variables. Considering both E:T ratios from 12:1 to 50:1 and Lytic Units, a significant reduction in NK activity was observed in the highest exposed workers compared to the low exposed. Multivariate analysis showed a significant negative correlation between exposure and LU, while no correlation was evidenced with other personal characteristics. ELF-MF are considered possible carcinogens, and existing data suggest that they can act as promoters. Due to the role of NK activity in host defence against cancer, the results obtained in this study in workers exposed to ELF-MF levels exceeding 1 microT are in agreement with this hypothesis, and support the need for further investigation in this field.
2009
- Natural killer cell activity decreases in workers occupationally exposed to extremely low frequency magnetic fields exceeding 1 μT
[Articolo su rivista]
Gobba, Fabriziomaria; Bargellini, Annalisa; Bravo, Giulia; M., Scaringi; L., Cauteruccio; Borella, Paola
abstract
In a preliminary study a reduction in Natural Killer (NK) cell activity in peripheral blood lymphocytes (PBL) was observed in a group of workers exposed to levels of Extremely Low Frequency- Magnetic Fields (ELF-MF) exceeding 1 microT. This study was performed to confirm the results. In 121 workers engaged in various occupational activities, individual ELF-MF exposure was monitored for 2 work shifts. Exposure levels were calculated as Time-Weighted Average (TWA). Subjects were classified as Low exposure (TWA ≤ 0.2 μT) Medium exposure (TWA 0.21-0.99 microT), or Higher exposure (TWA > 1 μT). In higher exposure workers NK activity proved significantly reduced compared to low exposure,(p<0.01). In medium exposure a reduction was also observed, but the difference was not significant. Multivariate analysis also confirmed the relation between exposure and NK activity. It has been suggested that ELF might affect tumour progression by inducing changes in the immune system: due to the role played by NK activity in host defence against cancer, the interference with the NK cell activity observed in this study is in agreement with this hypothesis. Furthermore, an increased risk for some neurodegenerative disorders has been reported in some epidemiological studies in ELF-MF-exposed workers: changes in NK function were also described in these diseases. Our results, showing the effect on NK activity of exposure exceeding 1 microT, suggest a possible mechanism for ELF-MF effects. This could open new horizons regarding the adverse long-term effects of these fields.
2009
- Validazione di un metodo innovativo per la determinazione quali-quantitativa di Legionella spp. in campioni idrici
[Abstract in Rivista]
Bargellini, Annalisa; Marchesi, Isabella; S., Cristino; A., Marcelloni; A., Chiominto; Frezza, Giuseppina; A., Mansi; E., Leoni; Borella, Paola
abstract
Obiettivi specifici. Validare un metodo innovativo basato sulla tecnologia di ibridazione in situ fluorescente per la determinazione quali-quantitativa di Legionella spp. in campioni idrici, attraverso uno studio multicentrico di confronto tra diversi laboratori.Materiali e metodi. Il metodo proposto (ScanVIT, Biocontrol Systems) è stato applicato su campioni di acqua prelevati in diverse strutture e campioni contaminati artificialmente con L. pneumophila in presenza/assenza di P. aeruginosa e confrontato con metodo colturale classico (ISO 11731:98). Lo ScanVIT prevede la concentrazione del campione mediante filtrazione su membrana che dopo decontaminazione viene seminata su terreno selettivo e dopo 72 h trattata con sonde geniche a DNA. Queste sonde sono marcate con fluorocromi e si legano specificamente alle sequenze bersaglio site sull’RNA 16S di Legionella, permettendo di identificare e contare le cellule vitali mediante un microscopio a fluorescenza; le microcolonie di Legionella spp. appaiono verdi e quelle di L. pneumophila rosse.Risultati. Il 63,7% dei campioni esaminati è risultato positivo con metodo ScanVIT rispetto al 56,6% con metodo colturale e in 7,9% dei positivi capace di rilevare la co-presenza di L. pneumophila e non pneumophila. Il metodo ScanVIT ha permesso inoltre di rilevare concentrazioni di legionella superiori con una differenza statisticamente significativa. L’analisi della regressione ha evidenziato l’esistenza di una forte correlazione positiva tra i due metodi (r=0,888, p<0,001). In campioni contaminati artificialmente si è confermata la maggior efficienza del metodo ScanVit sulla tecnica colturale sia in termini qualitativi (94,4% di positivi vs 83,3%) che quantitativi. Inoltre, in presenza di P. aeruginosa, la tecnica standard senza decontaminazione riduce al 50% l’isolamento di legionelle. Falsi negativi sono stati trovati alle basse concentrazioni: <60 CFU/L per ScanVIT e <600 CFU/L per tecnica standard.Conclusioni. Il test innovativo proposto offre vantaggi di tipo qualitativo e quantitativo rispetto alla tecnica tradizionale. È in grado di evidenziare un maggior numero di positività anche sui bassi livelli e in presenza di fattori interferenti come la co-colonizzazione con P. aeruginosa. Inoltre è capace di individuare più accuratamente la co-presenza di L. pneumophila e non pneumophila. Operativamente, si effettua con maggior rapidità e sicurezza per l’operatore, anche se sono emersi alcuni problemi di tipo tecnico facilmente risolti nei nostri laboratori. Il confronto tra laboratori dotati di elevata esperienza ha evidenziato una maggior sovrapposizione dei dati ottenuti con lo ScanVIT rispetto al metodo colturale.
2008
- Distribuzione e attività biologica del selenio in pazienti affette da tumore alla mammella
[Abstract in Rivista]
Bargellini, Annalisa; Piccinini, Lino; Marchesi, Isabella; Cauteruccio, Laura; Frezza, Giuseppina; R., Masironi; Borella, Paola
abstract
L’obiettivo del presente studio è stato quello di indagare sul ruolo del selenio nella insorgenza/evoluzione della patologia tumorale. Nella maggior parte degli studi epidemiologici, l’associazione tra Se e tumori è stata indagata misurandone la concentrazione totale nel plasma/siero, mentre una miglior comprensione dell’attività del Se può derivare dallo studio della sua distribuzione nelle diverse selenoproteine funzionalmente attive e nella modalità di accumulo nei tessuti neoplastici.Nell’ambito di uno studio caso-controllo su pazienti affette da tumore mammario, è stato pertanto misurato nel siero il Se totale e quello legato alla glutatione-perossidasi (GSH-Px), alla selenoproteina-P e all’albumina. Si è proceduto a misurare il Se in un prelievo bioptico dalla mammella, includendo sia un campione di tessuto neoplastico che di tessuto sano. Le tre principali proteine sono state separate tramite cromatografia di affinità e le analisi del Se sono state effettuate con metodo fluorimetrico.Dai nostri risultati, la concentrazione di Se totale nel siero è risultato solo lievemente inferiore nei casi rispetto ai controlli, ma nelle pazienti si riduceva significativamente il Se legato all’albumina. In termini di distribuzione percentuale, è stato evidenziato nelle pazienti un significativo “shift” del Se dalla frazione albuminica, che svolge una probabile funzione di deposito, verso la selenoproteina-P, di cui è nota la funzione di trasporto, e in misura inferiore verso la GSH-Px. L’analisi dei campioni bioptici ha evidenziato un maggior accumulo di Se nel tessuto malato rispetto al sano. Pur essendo questi risultati preliminari, è possibile ipotizzare che in presenza di patologia tumorale l’attivazione funzionale del Se, elemento noto per la sua attività antiossidante, venga stimolata per contrastare la crescita delle cellule neoplastiche. Il calo del Se plasmatico, evidenziato in molti studi epidemiologici, potrebbe essere interpretato come una conseguenza del suo richiamo dal torrente circolatorio verso i tessuti tumorali.
2008
- Effect of bacterial interference on biofilm development by Legionella pneumophila.
[Articolo su rivista]
E., Guerrieri; Bondi, Moreno; Sabia, Carla; DE NIEDERHAUSERN, Simona; Borella, Paola; Messi, Patrizia
abstract
In the ecology of Legionella pneumophila a crucial role may be played by its relationship with the natural flora; thus we investigated the interactions between Legionella and other aquatic bacteria, particularly within biofilms. Among 80 aquatic bacteria screened for the production of bacteriocin-like substances (BLSs), 66.2\% of them were active against L. pneumophila. The possible effect of some of these aquatic bacteria on the development and stability of L. pneumophila biofilms was studied. Pseudomonas fluorescens, the best BLS producer, showed the greatest negative effect on biofilm formation and strongly enhanced the detachment of Legionella. Pseudomonas aeruginosa, Burkholderia cepacia, Pseudomonas putida, Aeromonas hydrophila, and Stenotrophomonas maltophilia, although producing BLSs at different levels, were less active in the biofilm experiments. Acinetobacter lwoffii did not produce any antagonistic compound and was the only one able to strongly enhance L. pneumophila biofilm. Our results highlight that BLS production may contribute to determining the fate of L. pneumophila within ecological niches. The interactions observed in this study are important features of L. pneumophila ecology, which knowledge may lead to more effective measures to control the persistence of the germ in the environment.
2008
- Esposizione occupazionale a campi magnetici a frequenza estremamente bassa (ELF-MF) e attività natural killer in linfociti di sangue periferico
[Relazione in Atti di Convegno]
Gobba, Fabriziomaria; Borella, Paola; Bargellini, Annalisa; M., Scaringi; Bravo, Giulia; Giacobazzi, Pierluigi
abstract
I campi magnetici a frequenza estremamente bassa (ELF-MF) costituiscono un rischio di grande interesse nell’ambito della Medicina del Lavoro data la loro presenza praticamente ubiquitaria e per la loro classificazione tra i possibili cancerogeni per l’uomo (Gruppo 2B, IARC). In particolare, gli ELF-MF non sembrano causare effetti genotossici diretti, ma alcuni dati suggeriscono una possibile azione sulla promozione e/o sulla progressione. In accordo con questa possibilità sarebbero i risultati di alcuni studi che hanno osservato effetti a carico del sistema immunitario in seguito ad esposizioni occupazionali croniche ELF-MF. In particolare è stato riportato un effetto avverso sull’attività citotossica dei linfociti Natural Killer (NK); i risultati sono, però, finora limitati e poco conclusivi. Su questa base ci siamo proposti di esaminare gli effetti della esposizione occupazionale a campo magnetico ELF a carico dell’attività citotossica delle cellule NK nei linfociti di sangue periferico.E’ stato studiato un campione di 109 lavoratori addetti a diverse mansioni in vari comparti lavorativi. L’esposizione personale a campi magnetici ELF è stata valutata mediante dosimetria personale protratta per due turni lavorativi completi. I valori sono stati espressi come Time-Weighted Average (TWA) calcolati come media delle misurazioni nel periodo campionato.L’attività citotossica delle cellule NK è stata valutata nei linfociti di sangue periferico con un metodo basato sulla lisi di cellule target (T), costituite da cellule eritroleucemiche (Erythroleukaemic cell line K562) a differenti concentrazioni di cellule NK attivate (Effector cells -E-), e viene espressa sia come % di lisi a differenti rapporti tra NK e cellule target (E:T ratio: 100:1, 50:1, 25:1, 12:1, 6:1) ,che come numero di Unità Litiche (UL) per 107 linfociti. L’esposizione personale mediana nell’intero gruppo è risultata pari a 0,17 µT con 5° e 95° percentile rispettivamente 0,03 e 2,85 µT.Il campione è stato suddiviso in tre sottogruppi di esposizione: bassa esposizione (56 lavoratori; TWA 0,2 µT), esposizione intermedia (30 lavoratori; 0,2 <TWA < 1 µT), esposizione più elevato (23 lavoratori; TWA 1 µT).Nessuna differenza significativa è stata osservata nei rispettivi gruppi per le variabili demografiche e personali di rilievo (sesso, età, BMI, attitudine al fumo).Tra il gruppo a bassa esposizione ed il gruppo ad esposizione intermedia (0,2 <TWA < 1 µT) è stata osservata una significativa riduzione del numero di U.L. (57,43 vs 40,55; p =0,02). Ponendo invece a confronto il gruppo di soggetti a bassa esposizione (≤ 0,2 µT) con quelli ad esposizione più elevata (> 1 µT), non solo la riduzione delle U.L. viene confermata, ma emerge anche una significativa riduzione degli E:T ratio per tutte la concentrazioni testate.Questi risultati sono in accordo con un nostro studio preliminare, e confermano una possibile interferenza di un’esposizione cronica a livelli di ELF-MF superiori a 1 µT sull’attività funzionale delle cellule NK. Sebbene non sia possibile trarre delle conclusioni in ambito clinico, i risultati di questa osservazione sono coerenti con l’ipotesi di un possibile ruolo degli ELF-MF sulla promozione e/o progressione, mediante un effetto avverso sulla difesa immunitaria.
2008
- Gestione e controllo del rischio legionella nelle strutture sanitarie
[Abstract in Rivista]
Marchesi, Isabella; P., Marchegiano; Bargellini, Annalisa; Frezza, Giuseppina; Cauteruccio, Laura; Borella, Paola; D., Cavani; S., Cencetti
abstract
Il problema Legionella è particolarmente rilevante nelle strutture sanitarie per la frequente contaminazione degli impianti idrici e la presenza di pazienti ad elevato rischio di malattia, per cui le Direzioni Sanitarie devono attivare interventi mirati per prevenire la contaminazione, anche in assenza di casi. Accanto alle periodiche attività di manutenzione/pulizia degli impianti, le Linee Guida nazionali propongono diversi metodi di bonifica la cui efficacia nel medio e lungo periodo è tuttora da dimostrare. Su questa base, è stato condotto il nostro studio che mette a confronto i principali sistemi di disinfezione applicati nel corso di un decennio in un grande ospedale contaminato da Legionella. I trattamenti shock di iperclorazione e ipertermia, sia da soli che in combinazione, danno buoni risultati solo nel brevissimo periodo perché già dopo un mese si ha la ripresa della colonizzazione e dopo 6 mesi si raggiungono livelli simili o superiori a quelli iniziali. I trattamenti con biossido di cloro in continuo hanno portato in 6 mesi ad una progressiva riduzione della contaminazione senza giungere però alla completa eradicazione del germe, ed hanno evidenziato la necessità di un costante controllo del dosaggio del cloro per evitare ricolonizzazioni. Nelle stanze di degenza che ospitano pazienti più a rischio sono stati installati piccoli boiler a temperatura di oltre 55° C che garantiscono l’assenza di Legionella ai rubinetti e/o docce, con limitato impatto economico. Inoltre due palazzine costruite negli anni ‘90 sono tuttora esenti da contaminazione, molto presumibilmente per l’adozione di criteri costruttivi moderni e di elevata qualità. In conclusione, il nostro studio conferma la difficoltà ad eradicare Legionella dagli impianti idrici e sottolinea che diversi fattori quali tipo di pazienti, caratteristiche strutturali ed impiantistiche, oltre al tipo ed entità della contaminazione, devono essere attentamente valutati per decidere anche in termini costo-efficacia quale trattamento applicare.
2008
- La malattia dei legionari nei viaggiatori: epidemiologia, fattori di rischio e prevenzione
[Abstract in Rivista]
Borella, Paola; A., Borrello; Torcasio, Francesca; Bargellini, Annalisa; Marchesi, Isabella; G., Bucherini; Cauteruccio, Laura; Frezza, Giuseppina; L., Salizzato
abstract
La capacità di Legionella spp di sopravvivere nell’ambiente idrico come parassita intracellulare di protozoi e di associarsi ai biofilm spiega la scarsa efficacia dei biocidi e le difficoltà ad eradicare il germe dagli edifici pubblici e privati. Per questo motivo, per l’attenzione al problema e per il miglioramento delle capacità diagnostiche, la Malattia dei Legionari aumenta di anno in anno sia in Italia che in Europa e circa il 20% dei casi sono associati ai viaggi. Italia, Spagna e Francia sono i paesi più frequentemente visitati dai casi che insorgono in turisti e viaggiatori. L’Italia è quindi un paese particolarmente a rischio e questo può derivare dalla elevata frequenza ed entità di contaminazione delle nostre strutture turistico-alberghiere. Dal 2003, a seguito di un cluster epidemico, è stato condotto uno studio in una area costiera caratterizzata da strutture a prevalente apertura stagionale per verificare i fattori di rischio che si associano alla persistenza della contaminazione da Legionella e alla comparsa di casi tra gli ospiti, nonostante l’applicazione delle Linee Guida. I principali fattori associati alla comparsa di casi negli alberghi sono risultati la presenza di L. pneumophila sierogruppo 1, la contaminazione a livelli >10.000 CFU/L, e la percentuale dei siti contaminati all’interno della struttura (>60%). E’ emerso inoltre che le attività di manutenzione, pulizia e disinfezione per essere efficaci devono essere attuate dopo una attenta analisi del rischio che tenga in considerazione tutti gli aspetti degli impianti, compresa la modalità distributiva dell’acqua fredda. In sostanza, per limitare la legionellosi nei viaggiatori, è importante che i Dipartimenti di Prevenzione svolgano un ruolo di informazione e supporto per i gestori delle strutture turistico-alberghiere, al fine di favorire la corretta applicazione di protocolli di prevenzione, adeguatamente selezionati anche in termini costo-efficacia in funzione delle caratteristiche delle singole strutture.
2008
- Prevalence of anti-legionella antibodies among Italian hospital workers
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; Marchesi, Isabella; Rovesti, Sergio; G., Stancanelli; S., Scaltriti; M., Moro; M. T., Montagna; D., Tatò; C., Napoli; M., Triassi; S., Montegrosso; F., Pennino; C. M., Zotti; S., Ditommaso; M., Giacomuzzi
abstract
This study evaluated the prevalence of anti-legionella antibodies in workers at hospitals with a long-term history of legionella contamination. The hospitals are located in Milan and Turin, northern Italy, and in Naples and Bari, southern Italy. Antibody prevalence and titres of healthcare workers, medical and dental students and blood donors were assessed. In total 28.5% of subjects were antibody positive, most frequently to L. pneumophila serogroups 7-14. Major differences were observed in seroprevalence and type of legionella antibody in persons from different geographic areas. Healthcare workers had a significantly higher frequency of antibodies compared with blood donors in Milan (35.4 vs 15.9%, P<0.001), whereas in Naples both groups exhibited high antibody frequency (48.8 vs 44.0%) and had a higher proportion of antibodies to legionella serogroups 1-6. Dental workers had a higher seroprevalence than office staff in Bari, but not in Turin, where daily disinfecting procedures had been adopted to avoid contamination of dental unit water. No association was found between the presence of antibodies and the presence of risk factors for legionellosis, nor with the occurrence of pneumonia and/or flu-like symptoms. In conclusion, the presence of legionella antibodies may be associated with occupational exposure in the hospital environment, but there was no evidence of any association with disease.
2008
- Relation between psychoneuroendocrine profile in stressful conditions and antibodies to herpesvirus 6 and 7
[Articolo su rivista]
R., Vivoli; Rovesti, Sergio; Borella, Paola; Cermelli, Claudio
abstract
The aim of the present study is to evaluate whether the individual susceptibility to infectious disease is influenced by the psychological profile of cadets exposed to stressful events associated with military lifestyle in academy and if the neuroendocrine responses to stressful events is related with humoral immunity estimated by measuring antibody titres to human herpesvirus (HHV-6)7 (HHV-7) and to what extent it is influenced by personality traits. It has been observed that cadets with lower psychoaptitude scores (1-2) have a significant higher susceptibility to infectious disease (x2=7.95; p=0.019) compared to subjects with higher scores. A positive relationship between cortisol and antibody titers to HHV-6 (r=0.304; p=0.024) it has been found. It can be interesting to observe that antibody titers on HHV-6 are also related to psychoaptitude profile (r=0.239; p=0.044). The antibody titers to HHV-7 are negatively related to the 5 scales of BFQ and in particular with subdimension Co (cordiality) of BFQ (r=0.401; p=0.002). The survey carried out on over 1,500 cadets of the Military Academy of Modena shows that the susceptibility to infectious diseases during the first six months of admission to the Academy seem to be influenced by the psychoaptitudinal profile. The finding of a positive relationship between serum cortisol and antibody vs HHV-6 suggests that the impairment of the immune system linked to circulatory cortisol levels may induce a reactivation of a latent herpesvirus 6 with related increase of antibody titers.
2008
- Selenium interactions with essential and toxic elements in egg yolk from commercial and fortified eggs
[Articolo su rivista]
Bargellini, Annalisa; Marchesi, Isabella; L., Rizzi; Cauteruccio, Laura; R., Masironi; M., Simioli; Borella, Paola
abstract
The main objective of this work was to evaluate the interaction between selenium concentration in both commercial and Se-enriched eggs and other essential/toxic elements (Ca, Mg, Fe, Zn, Pb, and Cd), taking into account a possible synergic action of iodine. Commercial eggs were purchased from several sale points or directly from the producers (farmyard eggs). Fortified eggs were obtained by supplementing chickenfeed for 6 weeks with Se as sodium selenite (1.0 microg/g Se) or Se plus iodine (1.0 microg/g Se+3.7 microg/g I). Se in experimental egg yolks significantly increased over the basic value by 39% in the Se group and 61% in the Se+I group, suggesting that I addition may enhance Se absorption. Levels of Se in commercial yolks were identical in free-range, barn or battery eggs, but significantly lower in farmyard and higher in organic eggs where the Se content approximated that found in Se fortified eggs. A significant reduction in Cd was observed in Se+I treated yolks compared to both control and Se alone diet, thus suggesting a high sensitivity of Cd to the detoxifying effect of Se combined with I. Furthermore, Se+I supplementation was associated with a significant Zn reduction, a finding which needs clarification to avoid attempts to maximize one component affecting the levels of other essential elements.
2008
- Sorveglianza e controllo della Legionella
[Articolo su rivista]
Borella, Paola
abstract
Al Policlinico di Modena il controllo delle infezioni da Legionella spp è oggetto di uno specifico programma di sorveglianza, svolto in collaborazione tra Direzione Sanitaria e Dipartimento di Scienze di Sanità Pubblica dell'Università. L'ospedale ha organizzato fin dal 1999 un piano di sorveglianza ambientale per rilevare la presenza di legionelle nell'acqua e dal 2001 un piano di sorveglianza clinica che prevede il controllo su tutte le polmoniti di origine nosocomiale per individuare quelle sostenute da questo agente infettivo.
2007
- Biological, psychological and clinical markers of caregiver's stress in impaired elderly with dementia and age-related disease.
[Articolo su rivista]
Neri, Mirco; P. A., Bonati; M., Pinelli; Borella, Paola; I., Tolve; N., Nigro
abstract
Stress refers to the experience, produced through a person-environment transaction, that results in psychological or physiological distress. Everyday stress or hassles have a larger impact on health, in this frame caring for elderly disabled and/or demented persons have been shown to be a chronic role strain. The concept of stress and strain encompasses different levels of individual functioning (physiological, cognitive, affective, social). We studied whether 3 different distressing conditions show (i) different profiles in biological, psychological and clinical indices of stress, and (ii) different response to temporary environmental manipulation. A sample of 29 caregivers of elderly subjects temporarily institutionalized for (i) respite program, (ii) behavioral psychological symptoms of dementia (BPSD) in dementia-control and, (iii) a rehabilitation program after hip fracture, was assessed with clinical, psychological and biological measures. The BPSD appear to be the most powerful distressing factor, both at the beginning and at the end of the study. On the whole, to an improvement of patient's clinical picture, it corresponds only a partial improvement in stress indices of the caregiver. The slope of biological indices don not parallel those of psychological ones. Among psychometric indices, the pattern of recovery differentiate affective and cognitive domains. The "respite" care condition seems to be the less effective in reducing stress in the caregivers. The stress process should be considered in its different domains to allow a tailored intervention
2007
- Influence of aquatic microorganisms on Legionella pneumophila survival
[Articolo su rivista]
Guerrieri, Elisa; Bondi, Moreno; Borella, Paola; Messi, Patrizia
abstract
The ability of aquatic bacteria Pseudomonas fluorescens SSD (Ps-D) and Pseudomonas putida SSC (Ps-C) to support the persistence of Legionella pneumophila (Lp-1) in an artificial water microcosm was investigated for 42 day, at two different incubation temperatures. At 4 °C, individually suspended Lp-1 was no longer detectable just after 24 hours, while in co-cultures with Pseudomonas, Lp1 showed a better survival capability. At 30 °C, Lp-1 alone displayed high survival rates over the entire period of observation. When Lp-1 was inoculated with Ps-C and Ps-D, its count showed a marked decrease, followed by a gradual and costant decline.
2007
- Prevalenza di Malattia dei Legionari e studio caso-controllo sui fattori di rischio: risultati dello studio Multicentrico italiano
[Abstract in Rivista]
Borella, Paola; E., Leoni; M. T., Montagna; V., Romano Spica; G., Stancanelli; M., Triassi; Marchesi, Isabella; Cauteruccio, Laura; Bargellini, Annalisa
abstract
Obiettivi. Gli scopi dello studio erano individuare le polmoniti da Legionella tra i pazienti ricoverati per stabilire la prevalenza di malattia su base nazionale e indagare sui fattori di rischio ambientali, personali e immunitari associati con la comparsa di malattia. Metodi. In sei grandi ospedali, è stata condotta per 4 anni una sorveglianza attiva per individuare i casi tra i pazienti con polmonite. Il protocollo prevedeva la sistematica raccolta delle urine per la ricerca dell’antigene di L. pneumophila, delle secrezioni respiratorie e del siero come test di conferma. Come controlli sono stati inclusi soggetti sani e pazienti affetti da altre forme di polmonite. Sono stati raccolti dati sulle caratteristiche personali e sono state effettuate analisi biochimico-cliniche e di alcuni parametri immunitari. Risultati. In totale. sono stati individuati 189 casi comunitari su 6032 polmoniti (3,2%), 174 erano comunitari e 15 nosocomiali. Dallo studio caso-controllo sono emersi alcuni fattori di rischio quali il titolo di studio, il fumo passivo ed attivo, il soggiorno fuori casa e, tra le malattie concomitanti, la presenza di tumori, HIV e diabete. La malattia dei legionari è accompagnata da una significativo calo degli eritrociti, oltre ad alterazioni nel colesterolo, GPT, ferro e rame. Tra i parametri immunitari era significativa la diminuzione dei linfociti, delle cellule helper ed NK, quest’ultima particolarmente evidente nei soggetti <50anni senza patologie concomitanti. Conclusioni. La prevalenza della malattia tra le polmoniti ricoverate riflette quanto riportato da altre indagini. Dallo studio caso-controllo sono stati confermati alcuni fattori di rischio noti, mentre altri che notoriamente accompagnano i processi flogistici suggeriscono che la malattia si manifesta con una maggiore gravità rispetto ad altre polmoniti. Infine il calo delle cellule NK sembra spiegare perché anche soggetti giovani apparentemente sani ma esposti al fumo contraggono la Malattia dei Legionari.
2007
- Risk factors for particulate and microbial contamination of air in operating theatres.
[Articolo su rivista]
Scaltriti, Stefania; S., Cencetti; Rovesti, Sergio; Marchesi, Isabella; Bargellini, Annalisa; Borella, Paola
abstract
This study was designed to standardize dust collection in recently built operating theatres equipped with a continuous monitoring system. The objectives were to establish the relationship between microbiological and dust contamination, and then to compare those parameters with the main indicators of surgical activity in order to better define risk factors affecting air quality. The air quality during 23 surgical operations was studied in three conventionally ventilated operating theatres. Microbiological air counts were taken using both passive and active sampling methods. Air dust particles, > or =0.5 and > or =5 microm in size, were measured using a light-scattering particle analyser. The overall dust load was mainly (98%) composed of fine particulate matter, most probably due to its longer suspension time before settlement. These particles positively correlated with operation length, but not with surgical technique, suggesting that fine particles may be a good tracer of operation complexity. In contrast, the surgical technique was the main predictor for the concentration of particles > or =5 microm, with a higher risk from general conventional surgery compared with scope surgery. The frequency of door-opening, taken as an index of staff and visitor movement, was the main negative predictor of over-threshold values of both fine and larger dust particles but, conversely, was a positive predictor of raised bacterial counts.
2007
- SOPRAVVIVENZA E CRESCITA DI DIVERSI SIEROGRUPPI DI LEGIONELLA PNEUMOPHILA NELL’AMBIENTE ACQUATICO
[Abstract in Rivista]
Marchesi, Isabella; Bargellini, Annalisa; Cauteruccio, Laura; Rivasi, Marianna; Guerrieri, Elisa; Messi, Patrizia; Borella, Paola
abstract
Obiettivo. Scopo dello studio era di verificare la capacità di sopravvivenza e crescita, in forma libera e nel biofilm, di ceppi di Legionella pneumophila appartenenti a diversi sierogruppi (sgs) in un sistema sperimentale che simula un impianto distribuzione di acqua calda.Materiali e metodi. Il modello da noi allestito è paragonabile a quello di un condominio di medie dimensioni, dove l’acqua a 40°C circola mediante una pompa. Dopo la stabilizzazione del sistema, sono stati inoculati 107 ufc/L ciascuno dei sgs 1, 6 e 9. I prelievi dell’acqua e del biofilm formato su un tubo posto all’interno della vasca sono stati effettuati settimanalmente per 3 mesi.Risultati. Dopo una settimana dall’inoculo, si è osservata una netta prevalenza del sg 6, pari al 70% sugli altri due ceppi. Tale trend si è confermato nel tempo e dopo sette settimane il sg 6 rappresentava il 93% degli isolati, contro un 7% del sg 1 e un valore prossimo allo 0% per il sg 9. Successivamente, l’andamento si è modificato, con un progressivo aumento del sg 1 che a 90 giorni rappresentava il 47% degli isolati contro il 41% del sg 6 e il 12% del sg 9. Andamenti del tutto analoghi sono stati osservati anche nei campioni di biofilm.Conclusioni. I risultati confermano che a parità di inoculo, ceppi appartenenti a diversi sierogruppi della specie L. pneumophila si diversificano sia nella formazione del biofilm che nella esistenza in forma planktonica. Tra i ceppi saggiati, l’adattabilità maggiore era del sg 6, seguita dai sgs 1 e 9. Va inoltre osservato che la percentuale del sg 1 (dal 7% al 47% delle legionelle isolate) sembra rispecchiare quella ritrovata in condizioni reali, sia nelle abitazioni che negli alberghi, a conferma della validità del nostro modello sperimentale per indagare sui meccanismi di crescita ambientale di Legionella spp.
2007
- STUDIO IN VITRO SUI MECCANISMI PATOGENETICI ASSOCIATI ALLA VIRULENZA DI LEGIONELLA PNEUMOPHILA
[Abstract in Rivista]
Bargellini, Annalisa; Cauteruccio, Laura; Marchesi, Isabella; Borella, Paola
abstract
Obiettivo. Comprendere i meccanismi di virulenza di Legionella pneumophila nei confronti dell’ospite attraverso lo studio delle interazioni tra Legionella e macrofagi umani.Materiali e metodi. Per lo studio sono stati testati ceppi di Legionella pneumophila appartenenti al sierogruppo 1, ceppo altamente virulento responsabile di un caso clinico, e ai sierogruppi 6 e 9, confrontati con il ceppo di riferimento Philadelphia 1 (ATCC 33152) e saggiati su cellule macrofagiche umane in linea continua (U937). Sono state studiate l’attività citotossica, misurata come sopravvivenza fino a 72 ore dei macrofagi dopo contatto con Legionella a diverse concentrazioni (MOI); l’attività citopatogena, valutata come vitalità macrofagica dopo l’esposizione a Legionella per 2 ore; la crescita/sopravvivenza di Legionella nelle cellule ospiti e infine la produzione di citochine.Risultati. Nei tests di citotossicità la sopravvivenza dei macrofagi si modificava solo dopo 48 ore e alla MOI 1:1 dopo 72 ore il sierogruppo 1 si associava ad una significativa minore sopravvivenza delle U937 (35% vs 65%-76% degli altri sierogruppi) (p<0.05). Un comportamento analogo si è evidenziato per l’attività citopatogena alla MOI 10:1. I dati di crescita intramacrofagica suggerivano una maggior capacità del sierogruppo 1 ad entrare nel macrofago: dopo 2 ore le legionelle erano da 2 a 4 volte più concentrate rispetto agli altri ceppi. Il sierogruppo 9 invece manifestava una crescita più elevata solo dopo 48 ore.Discussione. I dati preliminari dello studio sembrano confermare che ceppi appartenenti a diversi sierogruppi di Legionella pneumophila possono avere caratteristiche di virulenza differenti, in grado di spiegare una diversa capacità di dare malattia. In particolare, il sierogruppo 1 manifestava una più rapida crescita intracellulare e una maggiore attività citotossica e citopatogena. Il sierogruppo 9 invece, più raramente coinvolto nella comparsa di malattia, pur crescendo attivamente nelle cellule macrofagiche, non era in grado di causarne la distruzione.
2007
- Sorveglianza clinica attiva per la ricerca di polmoniti da Legionella. Risultati e considerazioni per le strutture sanitarie.
[Articolo su rivista]
Marchesi, Isabella; Bargellini, Annalisa; S., Cencetti; P., Marchegiano; Cauteruccio, Laura; Casolari, Chiara; Borella, Paola
abstract
In an university hospital of about 900 beds, a clinical surveillance was activated to detect cases of Legionnaires' disease in patients affected by community and/or nosocomial-acquired pneumonia. In the hospital Legionella spp was detected in the hot water distribution system and various disinfecting and control procedures were adopted to reduce contamination. Contemporary, the clinical surveillance began with the systematic detection of Legionella urinary antigen among recovered pneumonia, seroconversion as confirmation test and the collection of respiratory secretions or other biological materials to isolate the microorganism in patients positive to the urinary antigen. From September 2003 to May 2005, 486 pneumonia were followed, 98 of which considered of nosocomial origin. In total, 15 cases of community-acquired Legionnaires' disease were detected by the urinary test, whereas no cases of nosocomial origin were found. The characteristics of the detected cases are described in comparison with the other pneumonia and the surveillance cost was evaluated. The systematic clinical surveillance for Legionella infections is feasible with limit costs, allows to detect community-acquired cases otherwise unknown and to ascertain the absence/presence of nosocomial-acquired pneumonia, irrespective of the environment contamination.
2007
- Studio del parassitismo intracellulare di diversi sierogruppi di Legionella pneumophila nei confrontidi Acanthamoeba polyphaga
[Abstract in Rivista]
Messi, Patrizia; Guerrieri, Elisa; Haskushi, E; DE NIEDERHAUSERN, Simona; Sabia, Carla; Bondi, Moreno; Borella, Paola
abstract
OBIETTIVO: Poiché il parassitismo costituisce un fattore chiave siaper l’ecologia che per la virulenza di L. pneumophila, abbiamo studiatoil comportamento di diversi sierogruppi in relazione a questoaspetto. MATERIALI E METODI:Tre ceppi di L. pneumophila di isolamentoidrico appartenenti ai sierogruppi 1, 6 e 9, e il ceppo di riferimentoL. pneumophila ATCC 33152 (Philadelphia-1) sono stati co-coltivaticon un ceppo di Acanthamoeba polyphaga per studiare invitro: (a) la cinetica di infezione (efficienza di ingesso nell’amebaa diversi tempi di infezione) e (b) la capacità di replicazione intracellularee la citopatogenicità nei confronti dell’ospite in un periodopost-infezione di 72 ore. RISULTATI: Il sierogruppo 1 ha mostrato la più rapida cinetica diinfezione e una sviluppata capacità di moltiplicazione all’internodell’ameba, pur consentendone una discreta conservazione. Diversoil comportamento del sierogruppo 6, che pur evidenziandouna buona capacità di replicazione intracellulare, ha mostratouna maggiore aggressività nei confronti dell’ospite, riducendone ilnumero e la vitalità. Il sierogruppo 9 è risultato meno adattato allavita intracellulare, denotando una ridotta efficienza di infezione edi replicazione ed una scarsa citopatogenicità. Philadelphia-1,nonostante appartenga al sierogruppo 1, era il meno efficientenell’infezione e nella replicazione e non ha influito sulla sopravvivenzadell’ameba. CONCLUSIONI: Le differenze emerse tra i ceppi allo studio risultanoparticolarmente interessanti in relazione alle potenzialità patogenedei sierogruppi a cui appartengono, dal momento che meccanismimolecolari simili presiedono la vita intracellulare nelleamebe e nei macrofagi. Il ceppo appartenente al sierogruppo 1,che è stato associato ad un caso clinico, ha infatti evidenziato unamaggiore specializzazione al parassitismo rispetto agli altri ceppiambientali. Il comportamento anomalo dimostrato dal ceppo diriferimento trova conferme solo parziali in letteratura e il fenomenoda cui è stato determinato rimane tuttora da definire.
2006
- Clinical and environmental distribution of Legionella pneumophila in a university hospital in Italy: efficacy of ultraviolet disinfection
[Articolo su rivista]
M., Triassi; A., Di Popolo; G. R., D'Alcala; Z., Albanese; S., Cuccurullo; S., Montegrosso; M., Crispino; Borella, Paola; R., Zarrilli
abstract
The molecular epidemiology of Legionella pneumophila in the ´V. Monaldi´ University Hospital was studied. Seven cases of nosocomial. Legionnaires´ disease were diagnosed between 1999 and 2003. Two clinical legionella strains obtained from two patients in the adult cardiac surgery unit (CSU) and 30 environmental tegionella strains from the paediatric and adult CSUs, neonatal, intensive care unit (NICU) and the cardiorespiratory intensive care unit (CR-ICU) were serotyped and genotyped. L. pneumophila serogroup 1/Philadelphia with an identical pulsed-field get etectrophoresis (PFGE) profile A was isolated from two patients in the adult CSU, and from three and one water samples taken in the adult CSU and the paediatric CSU, respectively, from 2001 to 2002. Furthermore, L. pneumophila serogroup 3 with an identical. PFGE profile B was identified in 20 environmental strains from all wards, L. pneumophila serogroup 3 with PFGE profile C was identified in a single environmental, strain from the CR-ICU, and non-pneumophila Legionello with identical PFGE profile D was identified in five environmental strains from the adult CSU, paediatric CSU and NICU. Ultraviolet irradiation was effective in disinfection of the hospital water supplies in the adult and paediatric CSUs contaminated by L. pneumophila clone associated with nosocomial. Legionnaires´ disease. In conclusion, these data demonstrate that two cases of nosocomial legionellosis were caused by the persistence of a single clone of L. pneumophilo serogroup 1/Philadelphia in the hospital environment, and that disinfection by ultraviolet irradiation may represent an effective measure to prevent nosocomial Legionnaires´ disease.
2006
- Epidemiological investigation on a suggestive case of Legionella pneumonia and public health implications
[Articolo su rivista]
Borella, Paola; Marchesi, Isabella; S., Boccia; R., Amore; R., Cagarelli; Casolari, Chiara; P., Marchegiano
abstract
We report a case of Legionella pneumonia in a patient with psoriasis. The clinical strain had an identical PFGE pattern of 1 subtype of L. pneumophila serogroup 1 isolated at low concentration in a sporting club bath. Diagnostic, clinical and epidemiological aspects are discussed for their relevant public health implications.
2006
- INFEZIONI DELLE VIE URINARIE (IVU): STUDIO DI PREVALENZA, AUDIT E FORMAZIONE DEL PERSONALE
[Abstract in Rivista]
E., Mazzini; C., Gentile; M., Fanti; C., Valentini; M., Prandi; D., Formisano; Mecugni, Daniela; M., Pinetti; F., Gambarelli; A., Campioli; Borella, Paola
abstract
ObiettiviLe IVU rappresentano la localizzazione più frequente tra le Infezioni Ospedaliere: nel 75-80% dei casi sono associate all’uso del catetere vescicale. Nell’ASMN di RE sono stati condotti uno studio di prevalenza puntuale sulle IVU ed un audit su conoscenze e comportamenti del personale infermieristico nella prevenzione di IVU.La prevalenza delle IVU nell’Ospedale è stata correlata con i principali fattori di rischio al fine di sottolineare le criticità nelle conoscenze e nella pratica dei comportamenti corretti.Materiali e MetodiCon una scheda-paziente predisposta ad hoc sono stati raccolti dati generali, dati relativi la presenza di IVU e loro complicanze. Per l’audit sulle misure di profilassi attuate dal personale sono stati utilizzati questionari anonimi autocompilati. Successivamente sulla base dei risultati si è formato un gruppo multidisciplinare, con competenze in tema di Risk Managment, Infezioni Ospedaliere e Processi Formativi (medici ed infermiere di direzione, infermiere epidemiologo, infermieri di area medica, chirurgica, critica, referenti della formazione aziendale ed universitaria), per l’organizzazione di un percorso formativo.RisultatiSono stati arruolati complessivamente 496 pazienti. La prevalenza di IVU è risultata 3,2%. Sono stati identificati come fattori di rischio: il sesso femminile, il cateterismo, l’età avanzata. Sono stati raccolti 194 questionari autocompilati da infermieri e C.I. da cui è emerso che i principali motivi della mancata/parziale adesione a pratiche/comportamenti efficaci per prevenire le IVU sono attribuibili nel 38% dei casi a mancata o carente cultura/formazione e nel 39% dei casi ad aspetti organizzativo/gestionali. Sono state focalizzate alcune criticità utilizzate poi per la definizione della formazione successiva.ConclusioniRitenendo che i dati relativi alla prevalenza delle IVU ed al tasso di cateterizzazione possano essere migliorati attraverso una maggiore appropriatezza dell’uso e della gestione del catetere, il gruppo multidisciplinare ha disegnato un progetto di formazione sul campo che, partendo dai punti critici emersi dall’audit, prevederà incontri rivolti a tutto il personale infermieristico.
2006
- L'epidemiologia della Legionellosi
[Relazione in Atti di Convegno]
Borella, Paola; Marchesi, Isabella; Bargellini, Annalisa; Cauteruccio, Laura; Rovesti, Sergio; Aggazzotti, Gabriella
abstract
La legionellosi è considerata una malattia emergente perchè è in forte aumento sia in Italia che nel resto dell' Europa. Le ragioni sono molteplici: maggiore attenzione alla diagnosi da parte dei medici, anche grazie ai nuovi test rapidi che permettono di identificare il caso precocemente, moltiplicazione delle occasioni espositive per intensificazione dei viaggi, tendenza a centralizzare la gestione e produzione di acqua potabile, utilizzo di tecnologie che producono aereosolizzazione dell'acqua. Inoltre, aumentano le persone a rischio di ammalare perchè portatori di fattori predisponenti il passaggio da infezione a malattia. Attualmente si segnalano in Italia circa 600 casi l'anno, un numero certamente sottostimato rispetto al reale perchè una sorveglianza attiva da noi condotta in pochi ospedali ha permesso di identificare 34 casi in soli 6 mesi e di stabilire che legionella è responsabile di circa il 4% delle polmoniti ricoverate.
2006
- LA PREVENZIONE DELLE LEGIONELLOSI NEI TURISTI
[Abstract in Rivista]
Borella, Paola; A. M., Borrello; G., Bucherini; Marchesi, Isabella; Bargellini, Annalisa; Cauteruccio, Laura; L., Salizzato
abstract
ObiettiviIl problema della legionellosi nei viaggiatori è di particolare interesse per la presenza di numerose strutture turistiche contaminate da Legionella. L’Italia risulta essere il secondo paese europeo per numero di casi nei viaggiatori, con una inevitabile ricaduta negativa sul turismo, tanto che nel 2005 sono state emanate dall’ISS linee guida intese a favorire l’adozione di sistemi di prevenzione da parte dei gestori di strutture turistico-recettive e termali. L’indagine qui riportata si riferisce alla comparsa di numerosi casi nella riviera romagnola ed ai successivi interventi mirati a contenere il fenomeno. Materiali e metodi. Nell’estate del 2003, sono pervenute al Dipartimento di Sanità Pubblica 10 notifiche di Malattia dei Legionari in persone che avevano soggiornato in alberghi della zona. Il Dipartimento ha immediatamente attuato un sistema di sorveglianza sulle strutture interessate, verificando la contaminazione del sistema idrico e l’adozione di opportune misure di bonifica ambientale. Al fine di prevenire la ricomparsa di casi, sono state attuati incontri di informazione/formazione con i gestori ed è stata resa obbligatoria, tramite ordinanza del Sindaco, la istituzione del registro della manutenzione idro-potabile per tutte le strutture alberghiere. Negli anni successivi è stato attuato un monitoraggio per verificare, a campione e sulle strutture interessate dai casi, se gli alberghi avevano adottato i protocolli di manutenzione e se risultavano ancora contaminati da Legionella. Risultati. Si è assistito nel tempo ad una progressivo adeguamento degli alberghi alle misure di prevenzione, con una radicale riduzione del numero di casi ed un progressivo aumento di strutture esenti da contaminazione.Discussione. Il nostro studio documenta che le misure per il controllo della legionellosi sono efficaci soprattutto se accompagnate da una attenta sorveglianza da parte degli igienisti del territorio, il cui ruolo nella informazione, gestione e controllo del rischio appare indispensabile sia nel momento della comparsa di casi che nel lungo periodo.
2006
- LEGIONELLA PNEUMOPHILA COME PATOGENO EMERGENTE IN SANITA’ PUBBLICA: NUOVE PROSPETTIVE PER LA VALUTAZIONE DEL RISCHIO
[Abstract in Rivista]
Marchesi, Isabella; Bargellini, Annalisa; Cauteruccio, Laura; Borella, Paola
abstract
Nell’ambito dello studio multicentrico sulle legionellosi in Italia, è stata avviata una ricerca sui meccanismi di interazione tra Legionella pneumophila ed ospite, al fine di individuare quali caratteristiche del germe consentono di indurre o meno l’infezione e la progressione verso la malattia.I dati epidemiologici raccolti in cinque anni di attività suggeriscono la netta prevalenza del sierogruppo 1 come agente responsabile dei casi, nonostante che questo rappresenti una minoranza degli isolati ambientali, mentre altri sierogruppi, più frequenti nell’ambiente, raramente si associano alla malattia. La nostra ipotesi di lavoro è che all’interno della specie pneumophila i diversi sierogruppi possano avere caratteristiche di virulenza diverse, tali da spiegare la differenza nella capacità di dare infezione/malattia.Nella fase iniziale del nostro studio vengono utilizzati modelli sperimentali di crescita/sopravvivenza di Legionella in macrofagi umani in linea continua per verificar la capacità citotossica del germe e l’interferenza con l’immunocompetenza del macrofago. L’aspetto innovativo della nostra ricerca riguarda il confronto tra ceppi di L. pneumophila a diversa virulenza e differente distribuzione clinico/ambientale.I risultati preliminari dei test di citotossicità condotti con legionelle e macrofagi in rapporto pari a 10:1 per un periodo di incubazione di 24 ore dimostrano che L. pneumophila sierogruppo 1 è in grado di uccidere una percentuale di macrofagi significativamente più elevata di altri sierogruppi di provenienza ambientale.Sono tuttora in corso gli esperimenti per valutare eventuali differenze nella replicazione intramacrofagica di diversi ceppi L. pneumophila assumendo come ceppo di riferimento L. pneumophila Philadelphia 1.
2006
- Prevalence of Legionnaires’ disease and Investigation on Risk Factors: Results on an Italian Multicentric Study.
[Relazione in Atti di Convegno]
Borella, Paola; S., Boccia; E., Leoni; F., Zanetti; Marchesi, Isabella; Bargellini, Annalisa; M. T., Montagna; D., Tato'; S., Montegrosso; F., Pennino; V., ROMANO SPICA; G., Stancanelli; Scaltriti, Stefania
abstract
We here present the preliminary results of a large multicentric study carried out in Italy to detect Legionnairs' disease among patients with pneumonia. The general objective was to better evaluate the prevalence of disease within various Italian regions in order to confirm the existing data on the disease frequency and to eventually verify differences related to the disease.
2006
- Prospective 3-year surveillance for nosocomial and environmental Legionella pneumophila: Implications for infection control
[Articolo su rivista]
S., Boccia; P., Laurenti; Borella, Paola; U., Moscato; G., Capalbo; A., Cambieri; R., Amore; G., Quaranta; F., Boninti; M., Orsini; G., Branca; G., Fadda; V., Romano Spica; G., Ricciardi
abstract
OBJECTIVES: To perform a 3-year, prospective surveillance program for legionnaires disease (LD) in a large university hospital in Rome, and to assess the usefulness of the hospital water monitoring program in predicting the risk of nosocomial LD. METHODS: Samples from patients with new cases of nosocomial pneumonia were sent for legionella laboratory investigations. Meanwhile, water samples for bacteriological analysis were collected every 6 months from high- and medium-risk hospital wards (10 in total). Legionella pneumophila isolates collected were serotyped and analyzed by pulsed-field gel electrophoresis. RESULTS: From June 2001 through May 2004, the pneumonia surveillance identified one case of nosocomial LD among 43 cases of nosocomial pneumonia (2.3%). Environmental investigations detected L. pneumophila in 12 (18.7%) of the 64 water samples, of which 50% belonged to serogroup 1. The L. pneumophila count and the percentage of positive locations never exceeded 10(2) colony-forming units/L and 20%, respectively, except when the LD nosocomial case occurred (positive water samples, 40%; L. pneumophila count, <10(2) colony-forming units/L). Genotyping showed 3 prevalent clones of L. pneumophila in the water distribution network, of which one persisted over the 3 years. One clone contained 3 different L. pneumophila serogroups (2, 4, and 6). CONCLUSIONS: The low incidence of nosocomial cases of LD appears to be associated with a low percentage (<20%) of positive water samples per semester and with a low contamination level (<10(2) colony-forming units/L). An infection control system for nosocomial LD should, therefore, be based on both environmental and clinical surveillance, together with the appropriate maintenance of the hospital water distribution system.
2006
- Relationship between trace elements and cardiovascular disease
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; Rovesti, Sergio; Marchesi, Isabella; Vivoli, Gianfranco; R., Masironi
abstract
Some trace elements have been studied for their alleged protective effects on cardivascular function (Cr, Mn, Se, Zn and Cu), others instead for their possible negative effects (Al, As, Cd, Fe, Hg, Pb and Cu- the latter being considered both protective and harmful). The results of recent epidemiological studies highlight the role of the most controversial elements: Fe, Se, Cr, Cd, Pb, Zn and Cu on cardiovascular disease (CVD).
2006
- Rischio infettivo associato all'acqua potabile. Parte I: Analisi del problema
[Articolo su rivista]
Marchesi, Isabella; Bargellini, Annalisa; Guerrieri, Elisa; Cauteruccio, Laura; Aggazzotti, Gabriella; Borella, Paola
abstract
Negli ultimi anni il riscontro di un aumento del numero di epidemie correlate all'utilizzo dell'acqua potabile ha portato a una maggiore attenzione alle problematiche connesse alla presenza di microrganismi patogeni nelle risorse idriche. Tra gli agenti batterici responsabili vi è anche Legionella.
2006
- Rischio infettivo associato all'acqua potabile. Parte II: il problema legionellosi.
[Articolo su rivista]
Marchesi, Isabella; Bargellini, Annalisa; Cauteruccio, Laura; P., Marchegiano; Borella, Paola
abstract
La diffusa presenza di Legionella nelle strutture pubbliche e private italiane e il rischio di malattia connesso è un problema emergente nell'ambito della Sanità Pubblica che richiede una speciale attenzione, anche perchè è possibile prevenirlo, ma solo attraverso la stretta collaborazione tra le diverse figure professionali coinvolte
2006
- STRATEGIES FOR INFECTION CONTROL OF NOSOCOMIAL LEGIONNAIRES’ DISEASE: FOUR-YEAR SURVEILLANCE EXPERIENCE IN A TEACHING HOSPITAL IN ITALY.
[Relazione in Atti di Convegno]
S., Boccia; Borella, Paola; V., ROMANO SPICA; P., Laurenti; A., Cambieri; G., Branca
abstract
Within the context of the Italian Multicentric Study of Legionellosis, we carried out a 4-year active prospective LD surveillance program in a large university hospital in Rome. We also assessed the usefulness of the hospital water monitoring program to predict the risk of nosocomial LD. In addition, the genetic correlation among the environmental L. pneumophila isolates collected was assessed by means of pulsed-field gel electrophoresis (PFGE) for epidemiological investigations.
2006
- Studio del comportamento intracellulare di Legionella pneumophila ed altri batteri acquatici in Acanthamoeba polyphaga
[Abstract in Rivista]
Guerrieri, Elisa; Messi, Patrizia; Contri, Miranda; Bondi, Moreno; Borella, Paola
abstract
In questo studio si è ritenuto interssante valutare le interazioni tra alcuni batteri ad habitat idrico e un ceppo di Acanthamoeba polyphaga, al fine di comprendere meglio il ruolo di tali microrganismi nell'ecologia di L.pneumophila.
2006
- Studio multicentrico italiano sulla Legionellosi. Contaminazione ambientale da Legionella spp in strutture pubbliche e private
[Relazione in Atti di Convegno]
Borella, Paola; E., Leoni; M. T., Montagna; V., Romano Spica; G., Stancanelli; M., Triassi; Marchesi, Isabella; Bargellini, Annalisa; Cauteruccio, Laura; R., Sacchetti; F., Zanetti; D., Tatò; C., Napoli; Scaltriti, Stefania; S., Montegrosso; F., Pennino; S., Boccia
abstract
Nel 2001 è stato avviato uno studio multicentrico a livello nazionale sulla Malattia dei legionari per approfondire le conoscenze su alcuni degli aspetti critici e tuttora poco conosciuti del rischio Legionellosi, con specifico riferimento alla realtà italiana. Questo studio, coordinato dall'Università degli Studi di Modena e Reggio Emilia vede la partecipazione di altre Università italiane dislocate lungo tutta la penisola, in modo da evidenziare eventuali differenze territoriali nella contaminazione ambientale e nell'infezione, nelle fonti di esposizione, nelle situazioni di rischio particolare. Vengono riportati i risultati più salienti, in quattro anni di attività del Gruppo Multicentrico Italiano di studio sulle Legionellosi, delle indagini ambientali ed in particolare la ricerca di legionella nell'acqua calda sanitaria di abitazioni ed alberghi, effettuata per stabilire la frequenza della contaminazione nelle diverse realtà geografiche e per individuare i fattori di rischio ad essa associati.
2005
- A critical evaluation of the role of trace elements in human cancer
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; Piccinini, Lino; Vinceti, Marco; R., Masironi; Vivoli, Gianfranco
abstract
The interest in the role of trace elements in cancer is increasing, particularly for those with a possible protective action, such as Se and Zn. Despite the vast amount of investigations already conducted, there is a need for further epidemiological studies to better understand what compounds, at what levels, and with which mechanism trace elements are involved in protection against a specific cancer type or groups of cancer. Critical aspects remain the search for the most appropriate biological indicators of body burden, the variability in biological activity according to chemical form and the current state of knowledge of the mechanisms of action which could be mediated by interference of the neuroendocrine and/or immune system. On the basis of our experience on the relationship between trace elements and cancer disease, we discuss the critical aspects of the problem and try to define guidelines for future research.
2005
- A multicenter study comparing different commercial tests for detection of Legionella urinary antigen
[Abstract in Rivista]
M. T., Montagna; D., Tatò; G., Spilotros; G., Barbuti; Borella, Paola; S., Stampi; G., Stancanelli; M., Triassi; C. M., Zotti; C., Casolari; Bargellini, Annalisa; E., Leoni; Scaltriti, Stefania; S., Montegrosso; S., Ditommaso
abstract
The detection of the specific Legionella Urinary Antigen (LUA) is actually the most used method to diagnose legionellosis, but some different tests are commercially available at the moment in Italy. The Italian Working Group on Legionella Infections carried out an investigations to compare the reproducibility of three commercial tests for LUA detection versus the Biotest Legionella Urinary Antigen EIA , which is declared to have the highest sensitivity and specificity, as well as the ability to recognize all species of Legionella.
2005
- Biossido di cloro per il controllo della contaminazione da legionella: l’esperienza dell’IRCCS S. Raffaele
[Abstract in Rivista]
Scaltriti, Stefania; M., Moro; P., Nizzero; G., Stancanelli; C., Ossi; C., Curti; P., Scarpellini; Borella, Paola
abstract
Dal 1998 il Comitato Infezioni Ospedaliere ha coordinato una complessa attività di prevenzione e controllo della legionellosi, avendo come obiettivi diagnosi precoce dei casi e contenimento della contaminazione ambientale. Il coinvolgimento di diverse professionalità ha permesso di sviluppare una accurata conoscenza del problema e delle soluzione tecniche più idonee all’applicazione nel nostro ospedale, caratterizzato da impianti di diverse epoche e caratteristiche costruttive. In questo ambito abbiamo valutato l’efficacia del sistema di disinfezione al biossido di cloro (ClO2) in due diversi settori della struttura.
2005
- Caratterizzazione fenotipica e genotipica di isolati ambientali di Legionella spp. raccolti in Italia durante quattro anni di sorveglianza
[Abstract in Rivista]
S., Boccia; Borella, Paola; R., Amore; K., Del Gigante; A., Stenico; M., Orsini; G., Fabio; R., Sacchetti; M. T., Montagna; C., Ossi; R., Zarrilli; G., Stancanelli; D., Tatò; M., Triassi; G., De Luca; V., Romano Spica; G., Ricciardi
abstract
Obiettivi: Valutare la clonalità di isolati ambientali di L. pneumophila tra diverse regioni in Italia e all’interno di alcune città, e descrivere la distribuzione dei sierogruppi (Sg) di L. pneumophila e delle specie di legionella rispetto al luogo di isolamento.Metodi: Nel contesto dello Studio Multicentrico Italiano sulla Legionellosi sono stati raccolti 234 isolati ambientali di Legionella spp. da 7 diverse città durante il periodo Ottobre 1999-Settembre 2003. L’isolamento è stato eseguito da campioni del circuito di acqua calda di 19 ospedali, 26 hotel, 22 abitazioni private e 4 case di riposo. La tipizzazione genetica degli isolati di L. pneumophila è stata effettuata mediante elettroforesi in campo pulsato (PFGE) e la sierotipizzazione mediante l’uso di anticorpi monoclonali. La identificazione delle specie di Legionella non-pneumophila è stata eseguita mediante sequenziamento dell’intero gene 16SrDNA. Risultati: L. pneumophila rappresenta l’89% (208/234) degli isolati ambientali raccolti e tra questi il Sg 6 risulta essere il più comune (33%; 68/208). Tra le restanti specie identificate, L. anisa, L. taurinensis e L. micdadei risultano essere le più frequenti (69% delle specie non-pneumophila). La PFGE ha mostrato una elevata eterogeneità genetica degli isolati di L. pneumophila (110 pulsotipi differenti), ad eccezione di alcuni ospedali al cui interno persistevano identici cloni nei 4 anni di sorveglianza. Profili altamente simili in PFGE si sono anche riscontrati a Modena tra alcune abitazioni distanti. Gli ospedali sono risultati essere più frequentemente contaminati da L. pneumophila rispetto d altre specie di legionella, in confronto alle abitazioni private e hotel.Conclusioni: Lo studio mostra una elevata eterogeneità genetica degli isolati di L. pneumophila tra le diverse città, e una clonalità dei ceppi all’interno di alcune strutture sanitarie, confermando i dati di letteratura sulla persistenza del microrganismo in taluni habitat.
2005
- Clinical and environmental surveillance of legionnaires’diseas in a northern italian hospital
[Abstract in Rivista]
Marchesi, Isabella; Guerrieri, Elisa; C., Casolari; P., Marchegiano; G., Mantovani; M., Attino; Borella, Paola
abstract
A surveillance programme was activated within university hospital of about 1,000 beds to search for cases of Legionnaires' disease in patients affected by either community and nosocomial pneumonia and to evaluate the environmental diffusion and control of Legionella spp. in hot wator distribution systems.
2005
- Esposizione a Legionella spp in ambiente clinico e odontoiatrico: risultati di uno studio multicentrico
[Abstract in Rivista]
Borella, Paola; Bargellini, Annalisa; Mazzini, Elisa; Calcagnile, Gian Luigi; D., Tatò; S., Di Tommaso; S., Montegrosso; E., Leoni; M., Moro; M. A., Coniglio
abstract
Nell'ambito di uno studio multicentrico sulle infezioni da Legionella in Italia, è stata condotta un'indagine conoscitiva sulla contaminazione nei sistemi idrici di alcuni grandi ospedali e sull'efficacia di alcuni sistemi di disinfezione. Per verificare se esiste per il personale un rischio di infezione/malattia, è stato effettuato uno studio sulla prevalenza di anticorpi anti-legionella nel personale delle strutture sanitarie esaminate.
2005
- IL RISCHIO LEGIONELLOSI IN SOGGETTI HIV POSITIVI
[Abstract in Rivista]
Marchesi, Isabella; Bargellini, Annalisa; G., Stancanelli; Scaltriti, Stefania; M., Moro; S., Pignato; M. A., Coniglio; G., Giammanco; G., Ribera d’Alcalà; F., Pennino; Borella, Paola
abstract
Obiettivi. Nell’ambito di uno studio multicentrico sulla legionellosi in Italia, questa indagine intende studiare il rischio espositivo nei soggetti HIV positivi, valutando sia la prevalenza di anticorpi anti-Legionella sia l’incidenza della malattia.Metodi. Sono stati reclutati 154 soggetti sieropositivi per HIV e 207 controlli, ugualmente distribuiti tra Nord e Sud Italia. A ciascun soggetto è stato prelevato un campione di sangue per la ricerca degli anticorpi specifici (metodo IFA) ed è stato somministrato un questionario per indagare i fattori di rischio personali ed ambientali associati ad un maggior rischio espositivo. Quattro casi di legionellosi sono stati individuati mediante ricerca dell’antigene di Legionella nell’urina (metodo EIA) e sieroconversione.Risultati. La positività per Legionella è risultata del 12,3 % negli HIV contro il 26,1 % dei controlli (p<0,001), con titoli anticorpali significativamente più bassi negli HIV rispetto ai controlli. Inoltre, è stata riscontrata una differenza nel tipo di anticorpi in relazione all’area geografica, con una maggiore frequenza di anticorpi anti L. pneumophila sierogruppi 1-6 e non pneumophila al Sud rispetto al Nord, sia negli HIV (46,2 % vs 0%) che nei controlli (15,2% vs 0% e 39,4% vs 9,5%). Non sono emerse correlazioni significative con i fattori di rischio e/o sintomi associabili con la legionellosi. I soggetti HIV positivi che hanno contratto la legionellosi presentavano un età media inferiore a quella dei casi comunitari reclutati, titoli anticorpali più bassi, una sintomatologia extrapolmonare più frequente e livelli significativamente inferiori di cellule natural killer.Conclusioni. I soggetti HIV positivi presentano sieropositività per Legionella con una frequenza inferiore ai controlli, a parità di fattori di rischio espositivi e personali. Questo potrebbe indicare una minore difesa all’infezione, che spiega anche la frequente comparsa della malattia segnalata negli ultimi anni tra i soggetti HIV positivi.
2005
- Is there a professional risk of Legionnaires’ disease? Results of a multicentric serological study.
[Abstract in Rivista]
Borella, Paola; Mazzini, Elisa; Bargellini, Annalisa; M. T., Montagna; D., Tatò; C., Napoli; S., Pignato; G., Giammanco; M. A., Coniglio; G., Stancanelli; Scaltriti, Stefania; L., Lopalco; C. M., Zotti; M., Giacomuzzi; M., Gentile; M., Triassi; G., Ribera D’Alcalà; F., Pennino
abstract
Despite Legionella spp. frequently contaminate water distribution systems of private and public buildings, the risk of infection/disease among workers is scarcely known. A multicentric survey was carried out to evaluate the seroprevalence of Legionella antibodies in different exposure risk groups accurately studying the related risk factors. Pneumonia events in the last 5 years and flu-like symptoms in the last year were also recorded.
2005
- Le legionellosi come problema emergente di Sanità Pubblica: attività del Gruppo di lavoro della SItI.
[Relazione in Atti di Convegno]
Borella, Paola; S., Boccia; F., Bruscolini; Calcagnile, Gian Luigi; A., Carducci; B., Casini; M., Clerici; S., Delia; C., Gabelli; P., Lagana'; E., Leoni; Marchesi, Isabella; E., Masale; A., Molinari; M. T., Montagna; A., Navarra; A., Pianetti; S., Pignato; V., ROMANO SPICA; G., Stancanelli; M., Triassi; G., Villa; C., Zotti
abstract
In questa nota riportiamo i risultati più salienti delle indagini condotte dal Gruppo di Lavoro sulle Infezioni da Legionella, che ha raccolto preziose informazioni sulla diffusione del microrganismo in abitazioni, alberghi, ospedali ed in strutture sinora poco considerate per il rischio legionellosi come stabilimenti balneari e torri di raffreddamento industriali. Di grande rilevanza sono anche gli studi sperimentali sui sistemi di disinfezione, il cui utilizzo risulta spesso problematico.
2005
- Legionella contamination in hot water of Italian hotels
[Articolo su rivista]
Borella, Paola; M. T., Montagna; S., Stampi; G., Stancanelli; V., Romano Spica; M., Triassi; Marchesi, Isabella; Bargellini, Annalisa; D., Tatò; C., Napoli; F., Zanetti; E., Leoni; M., Moro; Scaltriti, Stefania; G., Ribera D'Alcalà; R., Santarpia; S., Boccia
abstract
A cross-sectional multicenter survey of Italian hotels was conducted to investigate Legionella spp. contamination of hot water. Chemical parameters (hardness, free chlorine concentration, and trace element concentrations), water systems, and building characteristics were evaluated to study risk factors for colonization. The hot water systems of Italian hotels were strongly colonized by Legionella; 75% of the buildings examined and 60% of the water samples were contaminated, mainly at levels of >= 10(3) CFU liter(-1), and Legionella pneumophila was the most frequently isolated species (87%). L. pneumophila serogroup I was isolated from 45.8% of the contaminated sites and from 32.5% of the hotels examined. When a multivariate logistic model was used, only hotel age was associated with contamination, but the risk factors differed depending on the contaminating species and serogroup. Soft water with higher chlorine levels and higher temperatures were associated with L. pneumophila serogroup 1 colonization, whereas the opposite was observed for serogroups 2 to 14. In conclusion, Italian hotels, particularly those located in old buildings, represent a major source of risk for Legionnaires' disease due to the high frequency of Legionella contamination, high germ concentration, and major L. pneumophila serogroup 1 colonization. The possible role of chlorine in favoring the survival of Legionella species is discussed.
2005
- Micro- and macromethod assays for the ecological study of Legionella pneumophila
[Articolo su rivista]
Guerrieri, Elisa; Bondi, Moreno; C., Ciancio; Borella, Paola; Messi, Patrizia
abstract
The survival of a strain of Legionella pneumophila (Lp-1) inoculated in artificial water microcosms was investigated with and without an amoebal host and varying environmental conditions, such as biofilm formation, amount of nutrients and incubation temperature. The results obtained using short (micromethod) and long (macromethod) term methods showed that L. pneumophila Lp-1 dies rapidly at 4 degrees C in the macromethod assay. When the same temperature (4 degrees C) was applied to the micromethod assay, L. pneumophila Lp-1 survived for three weeks, although it progressively decreased. At an incubation temperature of 30 degrees C, the aquatic environment was more favourable and better survival emerged in the macromethod; in contrast.. this favourable temperature condition did not improve the survival of L. pneumophila Lp-1 cultured with the micromethod. The role of the protozoa Acanthamoeba polyphaga proved to be indispensable for legionella survival only when environmental conditions become unfavourable. (c) 2005 Federation of European Microbiological Societies. Published by Elsevier B.V. All rights reserved.
2005
- Rapporti tra elementi in traccia, ansietà e parametri immunitari in pazienti affetti da tumore
[Abstract in Rivista]
Piccinini, Lino; Bargellini, Annalisa; M., De Palma; Marchesi, Isabella; Borella, Paola
abstract
Obiettivi. Nell’ambito di una serie di studi avviati da tempo, abbiamo cercato di approfondire i rapporti tra elementi in traccia, parametri immunitari e tumori, tenendo in considerazione alcuni tratti di personalità quali l’ansietà, in grado di modulare sia la risposta immunitaria che la malattia neoplastica.Materiali e Metodi. In questo studio caso-controllo abbiamo esaminato 30 pazienti affetti dai più comuni tipi di neoplasia, reclutati al momento della diagnosi e prima di iniziare gli eventuali trattamenti chemio e radioterapici, e 30 soggetti sani di controllo. Se, Zn e Cu sono stati misurati nel plasma insieme all’enzima glutatione perossidasi (GSH-Px) e alla perossidazione lipidica. Zn e GSH-Px sono stati misurati anche negli eritrociti. Sono stati indagati alcuni parametri dell’assetto immunitario di base. Si è proceduto inoltre alla somministrazione e compilazione dello State-Trait Anxiety Inventory (STAI-Y1 eY2) per la misurazione del grado di ansietà.Risultati. Per quanto riguarda gli elementi in traccia, i pazienti avevano un elevato livello di Zn negli eritrociti rispetto ai controlli e, solo nei maschi, di Cu plasmatico, mentre la perossidazione lipidica era diminuita. I soggetti affetti da tumore erano più ansiosi e mostravano alcune modificazioni nell’assetto immunitario di base, in particolare un incremento significativo nella % delle cellule natural killer (NK) rispetto ai controlli sani. Solo nei pazienti è stata riscontrata una significativa correlazione positiva tra GSH-Px e ansietà di tratto e tra Cu plasmatico e ansietà di stato.Conclusioni. Nel nostro campione non sono emerse carenze nei livelli plasmatici degli elementi in traccia, probabilmente a causa del numero limitato di soggetti finora reclutati e della presenza di diversi tipi di tumore. L’aumento delle cellule NK nei pazienti fa ipotizzare l’attivazione di un meccanismo di difesa immunitaria per contrastare la progressione della malattia dal momento che queste cellule sono deputate alla sorveglianza nei confronti degli agenti infettivi e delle cellule a sviluppo tumorale. Particolarmente interessante anche perché finora poco indagato e per questo degno di ulteriori indagini il riscontro di un rapporto associativo tra gli elementi in traccia e un tratto di personalità quale l’ansia.
2005
- Risposta psiconeuroendocrinoimmunitaria allo stress psicofisico.
[Abstract in Rivista]
R., Vivoli; Rovesti, Sergio; Borella, Paola
abstract
Con il presente studio si intende valutare in quale misura le risposte biochimiche ed immunitarie indotte da condizioni di stress psico-fisico siano influenzate da alcuni tratti della personalità.
2005
- Role of direct bacterial interference and biofilm in legionella pneumophila water ecology
[Abstract in Rivista]
Messi, Patrizia; Bondi, Moreno; Marchesi, Isabella; Borella, Paola; E., Guerrieri
abstract
Aim of the present study was to investigate the interactions occurring between Legionella and other aquatic bacteria, particularly within the biofilm
2005
- Ruolo dell’interferenza batterica e del parassitismo nell’ecologia di Legionella pneumophila
[Abstract in Rivista]
Guerrieri, Elisa; Bondi, Moreno; Borella, Paola; Marchesi, Isabella; Messi, Patrizia
abstract
Obiettivi. Numerosi studi hanno ampiamente dimostrato che i protozoi rivestono un ruolo cruciale nell’ecologia di Legionella pneumophila, mentre meno nota è l’influenza dei batteri idrici, in grado di interferire con la sopravvivenza e la crescita dell’ospite protozoario. Al fine di comprendere meglio tale interferenza indiretta, abbiamo indagato la capacità di L. pneumophila (sierogruppo 1 e 7-14) e altri batteri acquatici di entrare e moltiplicarsi all’interno delle amebe. Metodi. Co-culture dei batteri in esame con un ceppo di Acanthamoeba polyphaga sono state allestite in Synthetic Tap Water (STW), incubate a 30°C e osservate per 24 ore, determinando ad intervalli regolari le conte intra ed extra cellulari. Risultati. Entrambi i ceppi di L. pneumophila sono risultati un grado di entrare e trovare riparo all’interno dell’ameba, ma non di moltiplicarsi, probabilmente a causa del breve periodo di incubazione. Burkholderia cepacia, Pseudomonas aeruginosa, Pseudomonas fluorescens e Aeromonas hydrophila hanno mostrato una maggior capacità di ingresso e replicazione intracellulare. Nelle co-colture di A. polyphaga e L. pneumophila (sierogruppo 1) condotte in presenza dei batteri acquatici è stato osservato che B. cepacia era in grado di ridurre l’ingresso di legionella nel protozoo. L’analisi microscopica delle co-colture, ha permesso di rilevare due differenti comportamenti. Il primo, mostrato da L. pneumophila e B. cepacia, era caratterizzato dalla presenza di pochi batteri all’interno delle cellule infettate del protozoo e dall’assenza di lisi entro 24 ore di incubazione. Il secondo, osservato in A. hydrophila e P. fluorescens, ha mostrato la presenza di un elevato numero di batteri intracellulari ed una lisi violenta dopo poche ore di co-incubazione. Conclusioni. Questo studio conferma la capacità dei batteri appartenenti alla naturale microflora degli habitat acquatici di interferire con i protozoi e quindi, indirettamente, con l’ecologia di L. pneumophila.
2005
- SELENIO IN UOVA BIOFORTIFICATE: CONFRONTO CON UOVA COMMERCIALI
[Abstract in Rivista]
Bargellini, Annalisa; Marchesi, Isabella; L., Rizzi; Borella, Paola
abstract
Obiettivi. Il selenio, micronutriente essenziale per l’uomo, sembra svolgere un ruolo protettivo nei confronti dell’insorgenza di malattie cronico-degenerative, in particolare del cancro, grazie alla sua attività antiossidante. La sorgente naturale di selenio è rappresentata dalla dieta e la sua concentrazione nei cibi dipende dalle caratteristiche geobotaniche dell’area di provenienza degli alimenti. Nell’ambito di uno studio sull’arricchimento delle uova con acidi grassi 3 e microelementi essenziali (Se e I), il nostro obiettivo era quello di verificare se la supplementazione con Se potesse realmente arricchire l’uovo con questo elemento contribuendo ad un miglioramento della qualità nutrizionale dell’uovo. Per confronto sono state esaminate uova presenti normalmente sul mercato.Metodi. La prova è stata condotta su sette gruppi di galline ovaiole, alimentate con un mangime di base solo o addizionato con I o Se o con entrambi i sali. Le uova commerciali sono state acquistate tenendo conto dei diversi sistemi di allevamento delle ovaiole.Risultati. Il Se si accumula prevalentemente nel tuorlo delle uova sia commerciali (1,040,28 g/g) che trattate (da 1,600,21 a 1,980,16 g/g, secondo il trattamento). La supplementazione con Se e ancora di più quella con Se + I si associava ad una riduzione del contenuto di Cd , in misura inferiore di Pb, e favoriva l’accumulo di acidi grassi 3. Tuttavia si è osservato una tendenza al calo di Zn nei prodotti supplementati.Discussione. La dieta con alga supplementata con Se+I è quella che sembra offrire il maggior numero di vantaggi sia qualitativi che nutrizionali. Con questa dieta si ottiene il maggiore accumulo di Se e di omega 3, e il minore assorbimento di metalli tossici come Pb e Cd nel tuorlo delle uova biofortificate. Nessuna differenza è emersa nelle uova commerciali in relazione al tipo di allevamento.
2005
- The Italian Multicentric Study on legionnaires' disease: four years on environmental and epidemiological surveillance
[Abstract in Rivista]
Borella, Paola; Marchesi, Isabella; M. T., Montagna; C., Napoli; S., Pignato; G., Giammanco; V., Romano Spica; S., Boccia; G., De Luca; R., Sacchetti; G., Stancanelli; Scaltriti, Stefania; M., Triassi; G., Ribera D'Alcalà; C., Zotti; A., Ruggenini Moiraghi
abstract
In order to search, isolate and subtype Legionella strains from hot water systems, a large survey on public and private buildings (hospital, hotels, homes) was conducted. The sampling sessions included a detailed investigation on the environmental and structural factors possibly associated with contamination.
2005
- The role of selenium and iodine in controlling some egg minerals
[Articolo su rivista]
L., Rizzi; Bargellini, Annalisa; Borella, Paola; A., Mordenti
abstract
Il ruolo del selenio e dello iodio nel controllo di alcuni minerali nell’uovo. Una prova è stata condotta su sette gruppi di galline ovaiole, alimentate con un mangime di controllo (C) o contenente: olio di lino (L), olio di pesce (F), olio ricco di DHA derivante dalla micro-alga Schizochytrium sp in presenza o meno (A) di 5ppm di ioduro di potassio (AI) o di selenito di sodio (ASe) oppure di entrambi i sali (AISe). I contenuti di selenio e di zinco e di altri minerali sono stati valutati nei tuorli delle uova. A fine prova la concentrazione di selenio era aumentata in modo significativo (P<0,001), mentre quella dello zinco si era ridotta (P<0,05) nei tuorli dei gruppi ASe e AISe. I valori di Ca, Mn, Fe, Cu, Cd e Pb non differirono tra i tuorli dei vari gruppi, a parte il cadmio, la cui concentrazione si era ridotta nel gruppo AISe, attestando una influenza di iodio e selenio sulla deposizione di questo metallo.
2005
- Water ecology of Legionella and protozoan: environmental and public health perspectives
[Articolo su rivista]
Borella, Paola; Guerrieri, Elisa; Marchesi, Isabella; Bondi, Moreno; Messi, Patrizia
abstract
Ecological studies on Legionella spp. are essential to better understand the germ sources in the natural environments, the mechanism of entry into man-made water systems and the factors enabling survival and growth in aquatic habitats. Legionella spp exhibits peculiar and multiple strategies to adapt to stressful environment conditions which normally impair other germ survival. These strategies include the ability to enter in a viable but non cultivable (VBNC) state, to multiply intracellularly within a variety of protozoa, such as amoebae, to survive as a free organism within biofilms and to be enhanced/inhibited by the presence of other aquatic bacteria. The host-parasite interaction has been shown to be central in the pathogenesis and ecology of L.pneumophila. The bacterial-protozoan interaction contributes to the amplification of Legionella population in water systems, represents a shelter against unfavourable environmental conditions, acts as a reservoir of infection, and contributes to virulence as primes the pathogen to infect human cells. Legionella is able to survive as a free organism for long periods within biofilms which are widespread in man-made water systems. Biofilm provides shelter and nutrients, exhibits a remarkable resistance to biocide compounds and chlorination, thus representing ecological niches for legionella persistence in the environments. A most extensive knowledge on biofilm-associated legionellae may lead to most effective control measures to prevent legionellosis. Lastly, new perspectives in controlling legionella contamination can arise from investigations on aquatic bacteria able to inhibit legionella growth in natural and artificial water systems.
2004
- Confronto tra diverse metodiche utilizzate per l’identificazione dell’antigene urinario di Legionella
[Abstract in Rivista]
M. T., Montagna; D., Tatò; G., Spilotros; Borella, Paola; E., Leoni; G., Stancanelli; M., Triassi; C. M., Zotti; Marchesi, Isabella; Bargellini, Annalisa; C., Lazzari; M., Aporti; S., Scaltriti; R., Ieri; G., Ribera D’Alcalà; S., Montegrosso; S., Ditommaso; M., Gentile
abstract
Scopo del presente studio è mettere a confronto 4 kits commerciali per la ricerca dell’Ag urinario.Complessivamente, sono stati esaminati 84 campioni di urine di pazienti con polmonite (42 positivi per Ag urinario e, per controllo, 42 negativi) provenienti dalle U.U.O.O. di Bari, Bologna, Milano, Modena, Napoli e Torino.
2004
- Genetic polymorphisms as susceptibility factors to Legionella pneumonia.
[Abstract in Atti di Convegno]
V., Romano Spica; M. T., Montagna; G., Stancanelli; M., Triassi; S., Montegrosso; S., Stampi; P. P., Legnani; A., Lazzarin; D., Tatò; Giacobazzi, Pierluigi; S., Boccia; D., Arzani; G., Gianfranceschi; G., Ricciardi; Borella, Paola
abstract
To the aim of evaluating a possible role of chemokine receptors (CCR) alleles in resistance to legionnaires' disease we studied the CCR5 32 and CCR264I mutations in a case-control study realised within a nationwide research network.
2004
- IL PROBLEMA DELLA DISINFEZIONE NEL CONTROLLO DI LEGIONELLA SPP NEGLI IMPIANTI IDRICI OSPEDALIERI
[Abstract in Rivista]
Marchesi, Isabella; M., Attino; P., Marchegiano; G., Mantovani; Basili, Consuelo; Bargellini, Annalisa; G., Pieroni; Borella, Paola
abstract
Obiettivo. Studiare la diffusione ambientale di Legionella spp nel sistema di distribuzione dell’acqua calda sanitaria di un grande ospedale e verificare l’efficacia nel breve e medio periodo dei trattamenti di iperclorazione.
2004
- Identificazione di isolati appartenenti al genere legionellaceae tramite sequenziamento dei geni 16S rDNA, girasi r RNA-Polimerasi B
[Abstract in Rivista]
M., Orsini; Borella, Paola; Marchesi, Isabella; E., Leoni; S., Stampi; M. T., Montagna; D., Tatò; M., Triassi; R., Zarrilli; L., Marinelli; S., Boccia; G., Ricciardi; V., Romano Spica
abstract
L'identificazione e lo studio delle relazioni filogenetiche tra microrganismi mediante sequenziamento genico ha avuto un incremento negli ultimi anni. L'attuale indirizzo è nel caratterizzare i batteri sequenziando più geni e operando un confronto fra le sequenze depositate nelle banche dati disponibili. Nel contesto di un progetto multicentrico di sorveglianza nazionale sullo studio di infezioni da Legionella spp. sono stati isolati in diverse regioni italiane microrganismi con forti somiglianze morfologiche e colturali al batterio L. pneumophila. E' stato valutato su questi isolati l'utilizzo dei metodi di tipizzazione molecolare basati sul sequenziamento e la caratterizzazione guidata da strumenti informatici.
2004
- Indagine multicentrica sui fattori di rischio correlati alla presenza di Legionella spp nell’acqua di strutture pubbliche e private.
[Abstract in Rivista]
Borella, Paola; M. T., Montagna; S., Stampi; G., Stancanelli; V., Romano Spica; M., Triassi; Bargellini, Annalisa; Marchesi, Isabella; D., Tatò; G., Spilotros; G., De Luca; R., Sacchetti; C., Ossi; P., Nizzero; P., Laurenti; U., Moscato; G., Ribera D'alcalà; S., Montegrosso
abstract
Obiettivi. Nell’ambito dello studio multicentrico italiano sulle legionellosi, è stata condotta una indagine per stabilire la diffusione di Legionella spp nei sistemi idrici di case, alberghi ed ospedali, identificando altresì i fattori di rischio associati alla colonizzazione.Discussione. La colonizzazione dei sistemi idrici è risultata molto frequente nelle abitazioni, soprattutto se dotate di sistemi centralizzati, ed assume proporzioni rilevanti in alberghi ed ospedali. Va tuttavia sottolineato che L.pneumophila sg1, responsabile della maggior parte delle polmoniti, colonizza raramente le abitazioni, ma è spesso presente negli alberghi, suggerendo la necessità di interventi prioritari di prevenzione nelle strutture turistico-alberghiere.
2004
- Interferenza microbica: quale ruolo nell’ecologia di Acanthamoeba polyphaga e Legionella pneumophila?
[Abstract in Rivista]
Messi, Patrizia; Guerrieri, Elisa; Bondi, Moreno; Borella, Paola
abstract
Data la necessità di comprendere meglio l'ecologia di L.pneumophila al fine di consentire la messa in atto delle giuste misure preventive per controllarne la diffusione, sono stati testati 28 ceppi batterici di provenienza idrica, ascritti in maggior parte al genere Pseudomonas, per la capacità di produrre batteriocine. Di questi 20 (71,4%) sono risultati in grado di produrre batteriocine attivecontro L. pneumophila e 4 (14,3%) si sono mostrati scarsi produttori. Nessuno dei 22 ceppi di legionella testati è risultato in grado di produrre batteriocine. Parallelamente, al fine di ottenere informazioni sui fattori favorenti o inibenti lo sviluppo e la sopravvivenza dei protozoi, sono state allestite co-colture di un ceppo di Acanthamoeba polyphaga associato a L. pneumophila ed altri batteri. E' stata osservata una considerevole variabilità tra i diversi ceppi nella capacità di penetrare nell'ameba e di influenzarne la sopravvivenza e la moltiplicazione.
2004
- LO STUDIO MULTICENTRICO ITALIANO SULLE LEGIONELLOSI: RICERCHE AMBIENTALI, SORVEGLIANZA EPIDEMIOLOGICA, STRATEGIE DI PREVENZIONE E CONTROLLO
[Abstract in Rivista]
Borella, Paola; Neglia, Rachele Giovanna; M. T., Montagna; C., Napoli; S., Pignato; G., Giammanco; V., Romano Spica; S., Boccia; P., Legnani; F., Zanetti; G., Stancanelli; Scaltriti, Stefania; M., Triassi; G., Ribera D’Alcalà; C. M., Zotti; A., Ruggenini Moiraghi
abstract
Obiettivi. L’obiettivo generale della ricerca è approfondire le conoscenze su alcuni aspetti critici e poco conosciuti del rischio legionellosi, attraverso un’indagine multicentrica che si avvale di un approccio integrato epidemiologico e biomolecolare. Metodi. Dal 2001 è in corso uno studio epidemiologico multicentrico per individuare la prevalenza di anticorpi anti-Legionella in gruppi di popolazione a diverso rischio espositivo e per identificare la frequenza di legionellosi su oltre 4.000 pazienti con polmonite, tramite la ricerca dell’antigene urinario di L.pneumophila e conferma colturale e sierologica. E’ prevista un’indagine sugli strumenti diagnostici più idonei all’applicazione su larga scala per una precoce individuazione dei casi e la caratterizzazione (studio caso-controllo) dei fattori di rischio correlati con l’insorgenza di malattia sia in termini di esposizione che di condizioni individuali predisponenti, incluso lo studio dei polimorfismi di alcuni geni correlati alla suscettibilità/resistenza dell’ospite. Contemporaneamente, viene effettuato un monitoraggio ambientale nelle strutture sanitarie ed in altri ambienti confinati per indagare sulla diffusione di Legionella nei sistemi idrici, caratterizzare i fattori associati alla colonizzazione e attuare idonee misure di prevenzione e disinfezione. Per definire il grado di correlazione tra sierotipi, genotipi e virulenza, i ceppi isolati durante la sorveglianza clinica ed ambientale vengono siero- e genotipizzati. Infine, è previsto un approfondimento sui meccanismi che favoriscono la presenza del microrganismo nei serbatoi ambientali e sui meccanismi di resistenza/suscettibilità all’infezione dell’ospite attraverso indagini in vitro per valutare l’interazione di Legionella con le amebe e la capacità di interagire con cellule macrofagiche. Risultati e considerazioni. I risultati complessivi dello studio, del quale vengono riportati i dati più significativi fin qui raccolti, permetteranno l’acquisizione di elementi utili per la valutazione del rischio legionellosi e l’adozione di appropriate misure di prevenzione negli ambienti di vita e di lavoro, con particolare riferimento alla sorveglianza e controllo delle infezioni di origine nosocomiale
2004
- Legionella infection risk from domestic hot water
[Articolo su rivista]
Borella, Paola; M. T., Montagna; V., Romano Spica; S., Stampi; G., Stancanelli; M., Triassi; Neglia, Rachele Giovanna; Marchesi, Isabella; Fantuzzi, Guglielmina; D., Tatò; C., Napoli; G., Quaranta; P., Laurenti; E., Leoni; G., De Luca; C., Ossi; M., Moro; G., Ribera D'Alcalà
abstract
We investigated Legionella and Pseudomonas contamination of hot water in a cross-sectional multicentric survey in Italy. Chemical parameters (hardness, free chlorine, and trace elements) were determined. Legionella spp. were detected in 33 (22.6%) and Pseudomonas spp. in 56 (38.4%) of 146 samples. Some factors associated with Legionella contamination were heater type, tank distance and capacity, water plant age, and mineral content. Pseudomonas presence was influenced by water source, hardness, free chlorine, and temperature. Legionella contamination was associated with a centralized heater, distance from the heater point >10 m, and a water plant >10 years old. Furthermore, zinc levels of <20 mg/L and copper levels of >50 mg/L appeared to be protective against Legionella colonization. Legionella species and serogroups were differently distributed according to heater type, water temperature, and free chlorine, suggesting that Legionella strains may have a different sensibility and resistance to environmental factors and different ecoloqic niches.
2004
- Legionella is an emerging Public Health problem
[Articolo su rivista]
Borella, Paola
abstract
The issue of Legionnaires' disease has emerged as a major public health problem, interesting not only researchers, but also managers of public and private organisations, those responsible for public health, the general population and occasionally magistrates.The cases of legionellosis are increasing as a result of improved etiological diagnostic methods, population lifesyles and characteristics which fovour the presence of the responsible organism in the environment which leads to the frequent exposure and transmission of the disease to at-risk groups whose relative numbers are growing.
2004
- Relación entre micronutrientes y enfermedades cardiovasculares: pruebas epidemiológicas
[Capitolo/Saggio]
Borella, Paola; Bargellini, Annalisa; Rovesti, Sergio; Basili, Consuelo; Mazzini, Elisa
abstract
En esta revision presentamos los resultados de los estudios epidemiologicos recientes sobre la function del hierro y el selenio en las enfermedades cardiovasculares (ECV). Ademas, se tratarà la relacion entre los oligoelementos toxicos/esenciales y la hipertension humana.
2004
- Ruolo dell’interferenza microbica nell’ecologia di Acanthamoeba polyphaga e Legionella pneumophila
[Relazione in Atti di Convegno]
Messi, Patrizia; Guerrieri, Elisa; Bondi, Moreno; Borella, Paola
abstract
-
2004
- Sette anni d’esperienza sulla sorveglianza e controllo della legionellosi in un grande ospedale del Nord Italia
[Abstract in Rivista]
G., Stancanelli; Scaltriti, Stefania; L., Lopalco; F., Mariani; P., Nizzero; C., Bonato; R., Ieri; C., Ossi; C., Curti; M., Moro; A., Ambrosio; Borella, Paola
abstract
Dal 1998 il CIO del S. Raffaele ha implementato un'intensa attività di prevenzione e controllo delle infezioni da Legionella. L'esperienza maturata in sei anni ha permesso di orientare le risorse alla realizzazione degli interventi più appropriati alla nostra realtà.
2004
- Sieropositività per Legionella spp in gruppi di popolazione a diverso rischio espositivo
[Abstract in Rivista]
Borella, Paola; Mazzini, Elisa; Bargellini, Annalisa; M. T., Montagna; D., Tatò; C., Napoli; S., Pignato; G., Giammanco; M. A., Coniglio; G., Stancanelli; Scaltriti, Stefania; L., Lopalco; C. M., Zotti; M., Giacomuzzi; M., Gentile
abstract
Obiettivo. Nonostante la frequente presenza di Legionella nei sistemi idrici degli ambienti di vita e di lavoro, il rischio di infezione e/o malattia negli esposti è poco conosciuto. E’ stata pertanto condotta una indagine sulla prevalenza di anticorpi anti-Legionella nei dipendenti di ospedali contaminati e nei soggetti HIV-sieropositivi.Metodi.: Sono stati arruolati oltre 500 soggetti, suddivisi in base alle categorie di rischio: dipendenti degli ospedali (medici, infermieri, ecc.), personale di unità odontoiatriche, idraulici, soggetti HIV-positivi e come controlli donatori di sangue e impiegati delle strutture esaminate. La presenza di anticorpi nel siero è stata valutata tramite test IFA, assumendo 1:128 come cut-off per la positività. In tutti i gruppi sono state raccolte informazioni sui fattori di rischio per l’esposizione, utilizzando un questionario standardizzato.Risultati. La prevalenza di anticorpi anti-Legionella era significativamente più elevata nei dipendenti dell’ospedale (33,8 vs 10,0%, p<0,001) e nel personale odontoiatrico (31,8 vs 9,1%, p<0,01) rispetto ai controlli. Non è stata invece trovata differenza negli idraulici (9,8 vs 17,6%) e nei soggetti HIV-positivi. La positività riguardava prevalentemente L.pneumophila sierogruppi 7-14 e il titolo prevalente era 1:256. L’analisi dei fattori di rischio effettuata tra i lavoratori ospedalieri non ha evidenziato alcuna associazione significativa, tranne che per l’utilizzo di docce nei luoghi di lavoro. Nessun dipendente ha contratto la malattia negli ultimi 5 anni.Discussione. La frequenza di sieropositività è particolarmente elevata nel personale ospedaliero e nei lavoratori dell’odontoiatria, mentre gli HIV-positivi e gli idraulici hanno livelli di anticorpi paragonabili alle popolazioni di controllo. E’ da sottolineare come anche in queste ultime la sieropositività non sia trascurabile (dal 9,1% al 17,6%). Nel personale ospedaliero, la più elevata frequenza di anticorpi anti-L.pneumophila 7-14 coincideva con la maggior diffusione di questi sierogruppi nell’ambiente, suggerendo che la positività sia espressione di esposizione più che di malattia in atto o pregressa.
2004
- Studio di prevalenza di anticorpi anti Legionella in soggetti HIV positivi confrontati con operatori sanitari operanti nella stressa struttura di ricovero
[Abstract in Rivista]
L., Lopalco; G., Stancanelli; Scaltriti, Stefania; R., Novati; P., Scalpellini; M., Cernuschi; Borella, Paola
abstract
Obiettivi:valutare la prevalenza di anticorpi anti-legionella in un gruppo di 78 soggetti sieropositivi per HIV, che frequentano con regolarità un ospedale colonizzato.Confrontare i dati con quelli relativi a 80 operatori della stessa struttura.Ricavare indicazioni sul rischio espositivo in questi pazienti.
2004
- The Italian Multicentric Study on Legionnaires’ disease
[Articolo su rivista]
Borella, Paola
abstract
The general objective of the Italian Multicentric Study on Legionnaires’ disease is the investigation of some of the critical aspects of this emerging disease, with a specific interest in the Italian situation. An epidemiological study is being conducted in different Italian localities to evaluate the diffusion of Legionella spp in the environment and the efficiency of some of the control strategies to detect cases, study their related risk factors and to establish the frequency of infection within groups at different exposure levels. The first results obtained from the research project are presented below.
2004
- The Italian Multicentric study on legionnaires’ disease: active surveillance to detect cases and investigation on risk factors.
[Abstract in Atti di Convegno]
Borella, Paola; M. T., Montagna; V., Romano Spica; G., Stancanelli; M., Triassi; R., Sacchetti; Neglia, Rachele Giovanna; C., Napoli; Scaltriti, Stefania; G., De Luca; S., Boccia; S., Montegrosso; Marchesi, Isabella
abstract
Aim of this study is to evaluate the frequency of nosocomial and community-acquired legionnaires' disease among patients with pneumonia recovered in big Italian hospitals, and to characterise the environmental, personal, immune risk factors in subjects which develop pneumonia.
2003
- Cytotoxic activities of natural killer (NK) lymphocytes in workers exposed to various levels of extremely low frequency magnetic field
[Articolo su rivista]
Gobba, F.; Bargellini, A.; Roccatto, L.; Giacobazzi, P.; Borella, P.
abstract
2003
- Diffusione ambientale di Legionella spp e frequenza di legionellosi in pazienti affetti da polmonite: primi risultati di uno studio multicentrico italiano
[Articolo su rivista]
Borella, Paola; M. T., Montagna; V., ROMANO SPICA; S., Stampi; G., Stancanelli; M., TRIASSI M; Bargellini, Annalisa; Giacobazzi, Pierluigi; Vercilli, Francesco; Scaltriti, Stefania; Marchesi, Isabella; C., Napoli; D., Tato'; G., Spilotros; N., Paglionico; G., Quaranta; M., Branca; M., Tumbarello; P., Laurenti; U., Moscato; E., Capoluongo; G., DE LUCA; P. P., Legnani; E., Leoni; R., Sacchetti; F., Zanetti; M., Moro; C., Ossi; L., Lopalco; R., Santarpia; V., Conturso; G., RIBERA D'ALCALA'; S., Montegrosso
abstract
A multicentric Italian investigation on legionnaires' disease is in course to clarify host factors as well as pathogen associated characteristics involved in the infection/disease. The main goal of the research plan is to account for some critical aspects concerning identification and prevention of legionellosis. To improve knowledge on factors associated with Legionella spp colonisation in hot waters, to detect cases and to characterize risk factors in subjects which develop pneumonia are specific objectives of the research programme. Preliminary results show that hot waters of houses and hotels are frequently contaminated (22.6% and 54.6%, respectively), mainly by L. pneumophila. Microbial concentrations were low in domestic waters (<1.000 ufc/l), but higher in samples from the hotels (geom. mean 1.85 x 10(3) ufc/l). Warming system, age of the plant, type of building were risk factors significantly associated with Legionella spp positivity. The active surveillance on patients affected by pneumonia with search for Legionella urinary antigen allowed the identification of 34 cases, 3 of which of nosocomial origin, corresponding to 4.2% of the screened pneumonia. After informed consent, 26 subjects were recruited for a case-control-study to clarify risk factors for the disease.
2003
- L'epidemiologia applicata al territorio: analisi della mortalità per tumore polmonare ed interventi di bonifica ambientale nel comune di Fiorano Modenes (Comprensorio Ceramico).
[Articolo su rivista]
Goldoni, Ca; Gambini, M; Vaccari, C; Soli, A; Ranzi, A; DE GIROLAMO, G; Valerio, L; Borella, Paola; Duca, G; Lauriola, P.
abstract
Mortality data in the province of Modena 1987-1996 show an excess for lung cancer in the municipality of Fiorano Modenese. In order to characterize the risk factors involved, a case-control study was carried out. Exposure to particulate matter was associated with lung cancer (OR 2.4 IC 95% 1.2-4.7). In the meantime, also as a consequence of this study, Fiorano Modenese Council started actions and obligations to control air pollutants emissions. The study is described as an example of good integration between local epidemiological knowledge and preventive interventions by Local Administration; problems and doubts surfacing from this experience are also pointed out.
2003
- La Scheda di Dimissione Ospedaliera: vantaggi e limiti nell'individuazione dei casi di legionellosi
[Articolo su rivista]
P., Trerotoli; M. T., Montagna; Borella, Paola; V., ROMANO SPICA; G., Stancanelli; M., Triassi; G., Serio; C., Napoli; S., Soldano; D., Tatò; Vercilli, Francesco; Gentile, Cinzia; G., Quaranta; M., Volpe; A., Ambrosio; R., Santarpia; S., Montegrosso
abstract
Despite legionellosis surveillance is active in Italy since many years, the disease notification appears still undervalued. A multicentric survey was carried out among 5 big Italian hospitals. It examined 11,435 discharge forms (1999-2001), reporting pneumonia diagnosis. Legionellosis (II class of notify system for infectious disease) was studied among pneumonia diagnosis by discharge forms. According to the ICD9-CM, there's no specific code for legionellosis (this disease is included among "others gram-negative pneumonia"). So the presumed pneumonia imputable to Legionella spp were the 2.7% of the whole number of analyzed discharge forms. Besides, the data regarding the other pneumonia showed that the etiological agent was specified only in the 11.2% of the case. This situation could be rectified both introducing adequate discharge forms codes and promoting the etiological diagnosis during the hospital stay.
2003
- Left atrial size and function after spontaneous cardioversion of atrial fibrillation and their relation to N-terminal atrial natriuretic peptide
[Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; L., Bonetti; Borella, Paola; Mattioli, Giorgio
abstract
In conclusion, higher levels of N-ANP during AF were independently associated with spontaneous conversion, as well as with smaller LA volume.An inverse correlation existed between LA volume and N-ANP
2003
- Relationship between mineral content of domestic hot water and microbial contamination
[Relazione in Atti di Convegno]
Borella, Paola; M. T., Montagna; V., ROMANO SPICA; S., Stampi; G., Stancanelli; M., Triassi; Marchesi, Isabella; Bargellini, Annalisa; Neglia, Rachele Giovanna; N., Paglionico; G., Spilotros; U., Moscato; G., Casati; P. P., Legnani; R., Sacchetti; C., Ossi; M., Moro; G., Ribera
abstract
The relationship between Legionella and Pseudomonas spp contamination and mineral content of domestic hot waters was investigated in a cross-sectional Italian survey. Pseudomonas spp contamination was associated with elevated Ca, but lower Fe and free chlorine content in the water. Waters with Cu concentrations > 50 microg/L prevented Legionella spp colonisation (OR = 0.14, 95% CI = 0.02-1.13), whereas the risk of legionellae occurrence increased in waters with Mn levels > 3 microg/L (OR = 2.37, 95% CI = 1.06-5.30). Furthermore, Mn was positively associated with the risk of colonisation by eterotrophic bacteria growing at either 22 and 36 degrees C. Legionella species and serogroups were differently distributed according to Cu and Mn concentrations, suggesting that Legionella strains may have a different sensibility/resistance to trace elements. A specific action of Cu as decontamination factor is suggested and the consideration of Mn as a risk indicator for bacterial colonisation and biofilm presence is proposed.
2003
- Selected papers of the Seventh Meeting of the Italian Association for the Study of Trace Elements in the Living Organisms (AISETOV). September 2002, Chieti, Italy: Editorial Note
[Articolo su rivista]
Borella, P.
abstract
The study was addressed to evaluate the in vitro iron and zinc dialysability from the globulin fraction of six legumes. Five Legume species including white bean, mottled bean (Taylor bean), chickpea, Lentil, lupin, and a modified mottled bean variety, selected by back-crossing to obtain seeds with globulins composed by G1 fraction only, were used. Globulins (G1 + G2) were extracted from the seeds and analysed for their in vitro iron and zinc dialysability. The highest globulin concentration was detected in Lentil (89%). The percentage of globulins in the modified variety of Taylor bean (G1 only) was higher than that of the commercial variety (G1 + G2). The highest concentration of iron was found in Taylor bean globulins. The modified variety of Taylor bean contained 2.6-fold higher iron concentration than the whole seed, and the commercial variety had 1.8-fold higher iron only. The highest zinc concentration was found in Lentil globulins. Also iron dialysability from globulins was markedly higher than that of the respective whole seed. The highest value of iron dialysability was found in Lentil (10.8%). Zinc dialysability was generally high (above 20%), but no significant differences between whole seed and globulins were detected. The results showed that globulins enhanced iron but not zinc dialysability. Lupin and the modified variety of Taylor bean showed a different behaviour in terms of mineral dialysability compared to the other legumes. The amino acid composition of the digestion products of whole seeds and globulins failed to evidence any direct influence on iron and zinc availability.
2003
- Selected papers of the Seventh Meeting on the Italian Association for the Study of Trace Elements in the Living Organism (AISETOV) Editorial note.
[Relazione in Atti di Convegno]
Borella, Paola
abstract
-
2003
- Trace elements, anxiety and immune parameters in patients affected by cancer
[Relazione in Atti di Convegno]
Bargellini, Annalisa; Piccinini, Lino; M., De Palma; Giacobazzi, Pierluigi; S., Scaltriti; M., Mariano; R., Roncaglia; Borella, Paola
abstract
The aim of this case-control study was to investigate the relationship between trace elements, immune parameters, and human cancer, taking into account some personality traits, such as anxiety, implicated in the modulation of both immune responses and pathology. Thirty patients affected by the most frequent cancer types were recruited at the onset of disease together with 30 healthy controls. Se, Zn and Cu were measured in plasma together with glutathione peroxidase (GSH-Px) activity, and lipid peroxidation (thiobarbituric acid-reactive substances--TBARS). Furthermore, Zn and GSH-Px activity were measured in red blood cells. A complete blood profile with the main lymphocytes subsets was obtained and the State-Trait Anxiety Inventory was applied to evaluate anxiety. The only differences found between trace element levels in cases and controls were significantly higher erythrocyte Zn in cancer patients and higher plasma Cu levels in male patients. In addition, subjects affected by cancer exhibited a significant reduction in TBARS levels, were more anxious, had lower total B cells percentage and T helper/T suppressor ratio, and had a higher percentage of natural killer cells. Interestingly, in patients only, GSH-Px in plasma was positively related to trait anxiety scores (p < 0.02) and Cu to state anxiety scores (p < 0.05). In conclusion, we could not confirm the existence of trace element deficiency in relation to cancer and no links between trace element levels and lymphocyte subsets were documented. However, interesting associations between state anxiety and Cu, and between trait anxiety and GSH-Px were observed thus deserving further investigations.
2002
- Fattori di rischio per la legionellosi: parametri immunologici e rapporto con alcuni elementi in traccia.
[Abstract in Rivista]
Scaltriti, S; Marchesi, Isabella; Stancanelli, G; Giacobazzi, P; Righi, Elena; Bargellini, Annalisa; Borella, Paola
abstract
-
2002
- Il burnout nel personale sanitario: riflessioni sui fattori predisponenti e sui meccanismi di difesa alla luce dei rapporti con il sistema immunitario
[Articolo su rivista]
Bargellini, Annalisa; Scaltriti, Stefania; Borella, Paola
abstract
Il burnout è una sindrome d’esaurimento fisico e mentale che si osserva dopo un lungo periodo di lavoro in situazioni di stress nelle professioni a stretto contatto con altre persone, in particolar modo nel personale sanitario. Sia le caratteristiche individuali che l’organizzazione e la tipologia del lavoro si associano al burnout e, più recentemente, in uno studio sui medici abbiamo osservato che anche alcuni tratti della personalità quali l’ansietà giocano un ruolo aggiuntivo nella comparsa della sindrome. Per verificare se l’esaurimento fisico dei medici allo studio potesse influire sullo stato di salute abbiamo indagato la loro situazione immunitaria. Contrariamente alle attese non è stato evidenziata un’immunosoppressione legata al sentirsi stanchi e distaccati emotivamente dal paziente ma un aumento selettivo d’alcune sottopopolazioni linfocitarie in rapporto alla realizzazione personale. Alla luce di questi dati riteniamo che il senso di gratificazione derivante dal proprio lavoro permette di contrastare il sovraccarico lavorativo e mantenere un buon livello di salute.
2002
- Natural killer activity in workers exposed to various levels of Extremely Low Frequency-Electromagnetic Fields (ELF-EMF)
[Abstract in Rivista]
Gobba, Fabriziomaria; Borella, Paola; L., Roccatto; Giacobazzi, Pierluigi; Bargellini, Annalisa
abstract
Data on the effects of Extremely Low Frequency (ELF) Magnetic Fields (MF) on immune system in humans are conflicting. The aim of this study was to evaluate the NK cytotoxic activity in peripheral lymphocytes of a group of workers exposed to different levels of ELF-MF.
2002
- Pulizia e disinfezione in ambiente domestico
[Relazione in Atti di Convegno]
Borella, Paola
abstract
La necessità di adottare una corretta prassi igienica negli ambienti domestici, adeguata agli attuali stili di vita ed efficace nella prevenzione delle patologie infettive comunitarie trova ampi consensi in ambito scientifico. Gli aspetti innovativi riguardano l'introduzione di disinfettanti e la scelta di procedure basate sullo studio dei punti critici di rischio. Particolarmente importanti sono gli interventi informativi-educativi per orientare le scelte e fornire adeguate conoscenze sulle specifiche modalità d'uso e sui possibili rischi.
2002
- Studio multicentrico sulla legionellosi in Italia
[Relazione in Atti di Convegno]
Borella, Paola; Marchesi, Isabella; Fantuzzi, Guglielmina; Neglia, Rachele Giovanna; Scaltriti, Stefania; M. T., Montagna; V., ROMANO SPICA; S., Stampi; G., Stancanelli; M., Triassi
abstract
Nel 2000 è stato attivato un gruppo di studio sulla legionellosi, il cui obiettivo generale è approfondire le conoscenze sulla frequenza di malattia, sui fattori di rischio, sulle fonti di infezione e sulla contaminazione ambientale, con riferimento specifico alla situazione italiana. Su questa base sono stati definiti gli obiettivi specifici:1) approfondire le conoscenze sulla diffusione ambientale di Legionella. Quest’indagine è stata svolta in impianti idrici di abitazioni e alberghi, accompagnando gli esami microbiologici con lo studio dei fattori ambientali e strutturali che possono contribuire alla presenza di Legionella;2) valutare la frequenza di legionellosi tra le polmoniti comunitarie e nosocomiali. La sorveglianza si effettua in 6 ospedali (Milano, Reggio E., Bologna, Roma, Napoli, Bari), con sistematica ricerca dell’Ag urinario di L. pneumophila nei pazienti ricoverati, e approfondimento diagnostico in caso di positività;3) effettuare uno studio caso-controllo per approfondire le conoscenze sui fattori di rischio comportamentali, personali, immunitari, e ambientali correlabili con l’insorgenza di malattia, mediante questionari ed esami laboratoristici mirati 4) studiare l’associazione tra infezione e fonte ambientale, effettuando un approfondimento mirato alla tipizzazione molecolare dei ceppi isolati.Lo studio multicentrico permette di verificare l’attendibilità delle stime di frequenza della malattia e la diffusione ambientale del microrganismo confrontando realtà geografiche e ospedaliere diverse tra loro. Una migliore definizione dei fattori di rischio per l’infezione può fornire indicazioni utili ai medici e alla popolazione generale.
2002
- Valutazione del carico di stress negli operatori del soccorso: studio preliminare.
[Abstract in Rivista]
Giacobazzi, P; Bargellini, Annalisa; Cacciari, Cristina; Righi, Elena; Borella, Paola
abstract
-
2001
- Effects of chronic exposure to anaesthetic gases on some immune parameters
[Articolo su rivista]
Bargellini, Annalisa; Rovesti, Sergio; Barbieri, Alberto; R., Vivoli; R., Roncaglia; Righi, Elena; Borella, Paola
abstract
A cross-sectional survey was carried out to evaluate the relation between occupational exposure to low levels of anaesthetic gases (nitrous oxide and isoflurane) and immune parameters. Fifty-one anaesthetists were recruited among different Services of Anaesthesiology and Reanimation. The control group consisted of non-exposed physicians, similar for gender, age, and job grade. Total number of lymphocytes, lymphocyte subpopulations and the natural killer (NK) cytotoxic activity were measured. Information on personal and professional characteristics and on short- and long-term exposure was collected. Percentages of T cells (CD3) decreased significantly in anaesthetists compared to controls, whereas numbers of NK cells (CD16(+)CD3(-)) increased. After correction for confounders, short-term (last 2 weeks) exposure was associated with a decrease in percentages of total T and T helper (CD4) cells. Furthermore, T helper percentages were significantly reduced with increasing individual exposure score evaluated on the basis of working days and levels of anaesthetic gases in operating rooms. A significant X-ray-associated increase of numbers and percentages of NK cells was lastly observed. Despite limited present exposure to anaesthetic gases, a specific derangement in lymphocyte subpopulations, with T lymphocytes more affected than B, has been observed.
2001
- Valutazione nelle sale operatorie dei rischi da agenti anestetici volatili attraverso l'interferenza con l'attività funzionale delle cellule linfocitarie
[Capitolo/Saggio]
Borella, Paola; Bargellini, Annalisa
abstract
Obiettivo dello studio è valutare l'interferenza dell'esposizione a gas anestetici con l'attività funzionale di cellule linfocitarie ed in particolare dei linfociti NK, il che avrebbe conseguenze rilevanti sui meccanismi di difesa contro le infezioni e la crescita di cellule tumorali. Verrà contemporaneamente valutato il numero totale di cellule linfocitarie circolanti, numero e percentuale delle cellule B, T, T helper, T suppressor, NK.
2000
- Clinical, Echocardiographic and Hormonal Factors Influencing Spontaneous Conversion of Recent-Onset Atrial Fibrillation To Sinus Rhythm
[Articolo su rivista]
Mattioli, Anna Vittoria; D., Vivoli; Mattioli, Giorgio; Borella, Paola
abstract
In conclusion, we observed that the most importantpredictor of spontaneous conversion in patientswith recent-onset AF was the development ofarrhythmia during sleep. Another relevant predictorwas an increased level of ANP during the arrhythmia.
2000
- La legionellosi come problema emergente di Sanità Pubblica: aspetti di sorveglianza, diagnosi e controllo ambientale alla luce di recenti esperienze ospedaliere
[Articolo su rivista]
Bargellini, Annalisa; F., Vercilli; Fantuzzi, Guglielmina; Borella, Paola; G., Stancanelli; C., Curti; R., Mazzucconi; A., Lazzarin; I., Manghi; L., Sircana; M., Pinotti; L., Rizzo
abstract
La malattia dei legionari è un problema ubiquitario, che interessa non solo il personale medico ospedaliero ma anche i medici operanti sul territorio, considerato che la maggior parte dei casi ha un'origine comunitaria, anche se i casi nosocomiali destano maggiore preoccupazione per la gravità.In questo studio vengono riportate le esperienze di due ospedali del Nord Italia sulla identificazione e sul controllo della legionellosi.
2000
- La sanificazione in ambiente domestico: benefici e rischiHygienic cleaning in the domestic setting: benefits and risks
[Articolo su rivista]
Borella, Paola
abstract
The introduction of hygienic cleaning in the domestic setting is justified by healthreasons, due to the increase at home of persons at risk for infections. Furthermore, social and cultural factors, such as deep changes in the family structure and reduced time devoted to home hygiene, suggest the opportunity to increase the use of products containing disinfectants. This procedure, however, may be associated with acute and chronic effects, particularly appearance of resistance, allergies, dermatitis and intoxication. The balance between benefit and risk is positive, but deserve long-term observations. In any case, information and educational interventions are mandatory to guarantee the selection of adequate products and their use at an appropriate level.
2000
- Parathyroid hormone-related protein in metastatic breast cancer induced hypercalcemia: A case report
[Articolo su rivista]
Graffeo, R.; Pagani, O.; Crivelli, M.; Zappa, F.; Borella, P.; Reiner, M.; Goldhirsch, A.
abstract
2000
- Parte 9° - I microelementi e l'uomo, Cap.26 - microelementi essenziali, probabilmente essenziali e tossici per l'uomo
[Capitolo/Saggio]
Borella, Paola
abstract
-
2000
- Parte 9°- I microelementi e l'uomo. Cap. 25 - Generalità
[Capitolo/Saggio]
Borella, Paola
abstract
-
2000
- Parte 9°- I microelementi e l'uomo. Cap. 27 - Microelementi e dieta
[Capitolo/Saggio]
Borella, Paola
abstract
-
2000
- Potenziali rischi per un eccesso di igiene in casa.Potential risks from an excess of hygienic cleaning in the domestic setting
[Articolo su rivista]
Borella, Paola; Aggazzotti, Gabriella; Angelillo, I. F.; Balli, Fiorella; Barbone, F.; Carpenè, E.; Cossarizza, Andrea; Chiericozzi, M.; Gobba, Fabriziomaria; Seidenari, Stefania; Triassi, M.; Vercilli, F.
abstract
The most relevant and recent risks associated with an excessive hygiene are here presented. Besides general observations on the relationship between hygiene and immune system, we discuss possible acute and chronic effects due to home exposure to detergents. The specific problem of hygienic cleaning introduced on a vaste scale at home requires the comparison with similar experiences in the hospitals,, evaluation of efficacy, comprhension of risks such as the selection of resistant micro-organisms.
2000
- Prevenzione e controllo dell'infezione da Legionella in ambiente ospedaliero
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; S., Pergolizzi; Aggazzotti, Gabriella; C., Curti; P., Nizzero; G., Stancanelli; R., Vaiani; G., Gesu; R., Mazzuconi
abstract
An outbreak of nosocomial legionnaires' disease in a hospital of Northern Italy is described, together with the epidemiological survey and the control measures adopted. Two patients developed Legionella pneumophila (serogroup 1) pneumonia, one (immunodepressed) died. The Task Group organised by the Health Service excluded other previous nosocomial infections, and made controls on patients and personnel of at risk units (all negative). An intensive programme of environmental sampling and educational activities on personnel have been carried out. The environmental surveillance revealed that the centralised hot water distribution system of the hospital was colonised with Legionella. Shock heating and hyperchlorination of water were applied, which reduced the number of contaminated sites short term, but recolonisation took place two months later. We underline the difficulties encountered to control Legionella by active surveillance of water quality; once the system is contamined, Legionella eradication may be difficult and expensive, and cases of hospital-acquired legionnaieres' disease are likely to occur.
2000
- Relation between immune variables and burnout in a sample of physicians
[Articolo su rivista]
Bargellini, Annalisa; Barbieri, Alberto; Rovesti, Sergio; R., Vivoli; R., Roncaglia; Borella, Paola
abstract
OBJECTIVES: To evaluate in a group of physicians the relation between burnout, demographic or job characteristics, anxiety, and immune variables. METHODS: Seventy one physicians of all grades were recruited among different departments to a cross sectional survey. The Maslach burnout inventory, scales of emotional exhaustion, depersonalisation, and personal accomplishment, the trait scale of anxiety inventory (STAI-Y2), and a questionnaire on personal and professional characteristics were administered. The immune profile included quantitative (number (%) of lymphocytes and subsets) and functional (natural killer cytotoxicity) measures. RESULTS: With a model of stepwise multiple regression analysis, emotional exhaustion was significantly affected by both personal (marital, sex) and job characteristics (qualification, working activity), whereas only patient contact explained a portion of variation in depersonalisation. Furthermore, trait anxiety was found to predict the Maslach burnout inventory scores. After correction for potential confounders, physicians who scored high levels of personal accomplishment showed significantly higher numbers of total lymphocytes, T cells (CD3), T helper cells (CD4), and T suppressor cells (CD8) than those who scored low levels. No other correlation was found between burnout and immune variables. CONCLUSIONS: In our group of relatively young physicians a high degree of personal accomplishment was associated with an increase in the number of peripheral lymphocytes, particularly T subsets. The meaning of this is not clear, although it could be speculated that to evaluate oneself positively, particularly with regard to work with patients in the health services, might help to stimulate the immune system. By contrast, there is no evidence that to work hard, to feel tired from work, and to have a cynical reaction towards patient care is related to immunosuppression.
2000
- Trace elements in hypertension
[Relazione in Atti di Convegno]
Vivoli, Gianfranco; Bergomi, Margherita; Borella, Paola; Rovesti, Sergio
abstract
This volume containing the proceedings of the tenth of the highly successful TEMA meetings, presents recent progress in the research. In this review we briefly summarize the controversial data reported in literature, as well as the results of our studies on the role played by some toxic and essential trace elements in the pathogenesis and development of hypertension.
1999
- Aspetti epidemiologici del burnout in un campione di medici anestesisti.
[Articolo su rivista]
Bargellini, Annalisa; Barbieri, Alberto; Rovesti, Sergio; Vivoli, R.; Borella, Paola
abstract
E’ stata condotta un’indagine trasversale su un gruppo di anestesisti, e per confronto su un gruppo di medici di sanità pubblica, per verificare se lo stress occupazionale misurato con il Maslach Burnout Inventory correla con alcune variabili personali e con la tipologia dell’attività lavorativa. I risultati indicano l’esistenza di un profilo di rischio secondo il quale non essere coniugati, essere di sesso femminile ed espletare mansioni superiori si associa ad un maggior livello di esaurimento emotivo, mentre la depersonalizzazione è correlata alle mansioni e alla tipologia del servizio in cui si opera. Va inoltre sottolineato che elevati livelli di ansietà correlano positivamente con l’esaurimento emotivo e negativamente con la realizzazione personale.
1999
- Emotional stability, anxiety, and natural killer activity under examination stress.
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; Rovesti, Sergio; M., Pinelli; R., Vivoli; V., Solfrini; Vivoli, Gianfranco
abstract
This study was performed to evaluate the relation between a stable personality trait, a mood state and immune response to an examination stress. A self-reported measure of emotional stability (BFQ-ES scale) was obtained in a sample (n = 39) randomly selected from 277 cadets; this personality trait was also investigated by completing a neuroticism scale (Eysenck personality inventory) and a trait-anxiety scale (STAI). Natural killer (NK) cell activity was measured at baseline, long before the examination time and the examination day. The state-anxiety scale evaluated the response to the stressful stimulus. Taking subjects all together, the academic task did not result in significant modification over baseline in NK cell activity. Subjects were then divided into three groups based on emotional stability and state-anxiety scores: high emotional stability/low anxiety, medium, and low emotional stability/high anxiety. Examination stress induced significant increases in NK cell activity in the high emotional stability/low anxiety group, no effect in the medium group, and significant decreases in the low emotional stability/high anxiety group. The repeated-measure ANOVA revealed a significant interaction of group x period (baseline vs. examination) for both lytic units and percent cytolysis. The results did not change after introducing coffee and smoking habits as covariates. Our findings suggest that the state-anxiety acts in concert with a stable personality trait to modulate NK response in healthy subjects exposed to a psychological naturalistic stress. The relation between anxiety and poor immune control has been already described, whereas the ability of emotional stability to associate with an immunoenhancement has not yet reported. The peculiarity of our population, a very homogeneous and healthy group for life style and habits, can have highlighted the role of emotional stability, and may account for the difference with other studies.
1999
- I microelementi nell'alimentazione e nutrizione umana
[Articolo su rivista]
Borella, Paola; Vivoli, G.
abstract
.
1999
- Magnesium supplementation in Gitelman syndrome
[Articolo su rivista]
A., Bettinelli; E., Basilico; M. G., Metta; Borella, Paola; P., Jaeger; M. G., Bianchetti
abstract
The metabolism of potassium and magnesium are closely linked (in situations where potassium and magnesium depletion coexist, magnesium restoration alone is sufficient to correct hypokalemia). Moreover, magnesium deficiency blunts the interplay between circulating calcium and the calciotropic hormones. Renal magnesium wasting, hypokalemia, alkalosis, hypocalciuria, and a tendency towards hypocalcemia characterize Gitelman syndrome. Plasma or intracellular potassium, circulating calcium, and calciotropic hormones were therefore investigated in eight patients (4 females, 4 males, aged 9-20 years) with Gitelman syndrome before and during oral supplementation with magnesium pyrrolidone carboxylate 30 mmol daily for 4 weeks. Magnesium supplementation significantly increased plasma and intracellular magnesium and plasma calcium, but failed to completely restore magnesium deficiency. In contrast, blood levels of parathyroid hormone and calcitriol and plasma and intracellular potassium were not modified following magnesium administration.
1999
- Micro e macroelementi essenziali nella dieta di diversi gruppi residenti in comunità
[Articolo su rivista]
Bargellini, Annalisa; E., Caselgrandi; I., Voglioso; Borella, Paola
abstract
In questo studio abbiamo analizzato pasti pronti per il consumo per verificare il contenuto di alcuni elementi essenziali nella dieta di diversi gruppi residenti in comunità (struttura militare, residenza per anziani, ospedale).
1999
- Surveillance of legionellosis within a hospital in northern Italy: May 1998 to September 1999
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; S., Pergolizzi; Aggazzotti, Gabriella; C., Curti; P., Nizzero; G., Stancanelli; R., Vaiani; G., Gesu; R., Mazzuconi
abstract
In May 1998, a single case of nosocomial legionellosis was discovered in a 1000 bed hospital in Milan, which included departments serving immunocompromised and severely ill patients (transplant recipients, AIDS cases, patients receiving corticosteroids, etc.). This infection provided an opportunity to undertake a long term epidemiological and environmental survey. After 15 months of active surveillance, we have generated some suggestions for management of legionnaires’ disease acquired both in hospital and in the community.
1999
- Un nuovo corso di laurea della facoltà di Medicina e Chirurgia
[Articolo su rivista]
Aggazzotti, Gabriella; Borella, Paola; Righi, Elena
abstract
-
1998
- Acute renal failure of medical type in an elderly population
[Articolo su rivista]
Baraldi, A; Ballestri, M; Rapana, R; Lucchi, L; Borella, Paola; Leonelli, M; Furci, L; Lusvarghi, E.
abstract
One hundred and nine unselected patients with Acute Renal Failure (ARF) of medical aetiology were hospitalized at the Nephrological Unit of Policlinico University Hospital (Modena) during a 30-month period. ARF was considered as a rapid increase of serum creatinine > 2mg/dl over the baseline level or the doubling of pre-existing value in chronic renal failure. Mean age of patients was 67+/-17 years and median age was 72; 64.2% needing dialytic treatment. Four main causes of ARF were identified: 33 patients had reduced renal perfusion by dehydration, hypotension etc.; 20 multifactorial aetiology; 14 biopsy-investigated renal parenchymal diseases and 39 had drug-related acute renal failure (D-ARF). The clinical outcome was significantly worse in elderly patients as regard mortality (P < 0.02), chronic dialytic treatment (P < 0.04) and complete recovery (P < 0.004). The mean age of D-ARF patients was significantly greater than remaining ARF patients (72.6+/-12.8 vs 63.2+/-18.5: P < 0.004. Nonsteroidal antiinflammatory drugs (NSAIDs) and ACE-inhibitors (Ace-i) caused ARF in 24 and 8 patients respectively. Elderly age, vascular disease and monoclonal gammopathy represented the main risk factors and were significantly more frequent in D-ARF patients (P < 001, < 0.01, < 0.04 respectively). Our data confirm the high susceptibility of ageing kidneys to nephrotoxic damage caused by drugs affecting glomerular autoregulation by microvascular mechanisms. Greater attention to renal changes in ageing and an increased dissemination of preventative measures among nephrologists, could reduce the incidence of these serious and potentially lethal diseases.
1998
- Indagine sui livelli ematici e tissutali di Se, Zn e Cu in pazienti con patologia neoplastica.
[Poster]
Piccinini, L; Borella, Paola; Bargellini, Annalisa; Arigliano, V; Zanelli, F; Franchini, M; Zoboli, A; Fontana, I; Morandi, Uliano; Stefani, Alessandro
abstract
nd
1998
- Oxidative modification of aldose reductase induced by copper ion. Factors and conditions affecting the process
[Articolo su rivista]
I., Cecconi; M., Moroni; P. G., Vilardo; M., Dal Monte; Borella, Paola; Rastelli, Giulio; Costantino, Luca; D., Garland; D., Carper; J. M., Petrash; A., Del Corso; U., Mura
abstract
Bovine lens aldose reductase (ALR2) is inactivated by copper ion [Cu(II)] through an oxygen-independent oxidative modification process. A stoichiometry of 2 equiv of Cu(II)/enzyme mol is required to induce inactivation. While metal chelators such as EDTA or o-phenantroline prevent but do not reverse the ALR2 inactivation, DTT allows the enzyme activity to be rescued by inducing the recovery of the native enzyme form. The inactive enzyme form is characterized by the presence of 2 equiv of bound copper, at least one of which present as Cu(I), and by the presence of two lesser equivalents, with respect to the native enzyme, of reduced thiol residues. Data are presented which indicate that the Cu-induced protein modification responsible for the inactivation of ALR2 is the generation on the enzyme of an intramolecular disulfide bond. GSH significantly interferes with the Cu-dependent inactivation of ALR2 and induces, through its oxidation to GSSG, the generation of an enzyme form linked to a glutathionyl residue by a disulfide bond.
1998
- Plasma, hair and tissue levels of trace elements in lung cancer
[Relazione in Atti di Convegno]
Piccinini, Lino; Borella, Paola; Bargellini, Annalisa; Morandi, Uliano; Stefani, Alessandro; V., Arigliano; Davalli, Pierpaola
abstract
The purpose of this study was to investigate the relationship between plasma, hair and tissue levels of Se, Zn and Cu, and cancer.
1998
- Selenium determination in biological matrices
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; Caselgrandi, Eva; A., Menditto; M., Patriarca; A., Taylor; Vivoli, Gianfranco
abstract
In this study, we discuss some relevant aspects concerning the determination of selenium in biological materials with special reference to fluorometry and hydride generation atomic absorption spectroscopy (HG-AAS) techniques. The two methods may be applied without modifications to the analysis of Se in a wide spectrum of specimen types, and we describe their reliability in serum and hair analyses. Thirty-six independent control serum samples, the concentrations of which were unknown to the analyst, were analyzed in duplicate using both techniques in the Italian External Quality Assessment Scheme (EQAS). Accuracy was assessed by comparing Se values with those previously assigned by the organizers of the scheme using graphite furnace atomic absorption spectrometry (GF-AAS), which is the most frequently used technique for selenium determination in serum among the participants in the Italian EQAS. The results confirmed that fluorometry has a higher degree of accuracy than HG-AAS: the mean differences between observed and expected values were 1.5 mu g/liter (95% confidence interval, -1.06 to 3.97) for fluorometry and -1.1 mu g/liter (95% confidence interval, -5.05 to 2.76) for Hg-AAS. We also report some results obtained for the determination of Se in hair. Since a critical step in hair preparation is the pretreatment for removal of external contamination, we compared six different washing procedures. In general, Se is pearly leached from hair, but the efficiency of removal differed with the substance used, ranging from 0 to 13% of the original content. A nonionic detergent like Triton X-100 offers the advantage of safe working conditions and a substantial reduction in costs compared with organic solvents. Lastly, in a consistent group (n = 131) of women, Se in hair was found to be strongly reduced by the use of dye (389.9 ng/g vs 498.7 ng/g, P < 0.001). We recommend recording information on cosmetic treatments when hair is collected to evaluate Se reference values in epidemiological studies.
1998
- Selenium interaction with human cell functions
[Relazione in Atti di Convegno]
Borella, Paola; Bargellini, Annalisa; V., Solfrini
abstract
We undertook a series of in vitro studies to evaluate the effects of different doses and compounds of selenium on functional activities of human lymphocytes. The NK cell activity and the proliferation and antibody release by cultured lymphocytes were studied. Our studies suggest that an excess of Se may have a detrimental effect on certain immunological parameters. In addition, Se bioavailability more than absolute levels should be considered to better understand the Se role on immune system
1998
- Selenium, Zinc and Copper il lung cancer: modifications in fluids and tissues
[Abstract in Atti di Convegno]
Piccinini, L; Borella, Paola; Bargellini, Annalisa; Morandi, Uliano; Stefani, Alessandro; Arigliano, V; Davalli, P.
abstract
nd
1998
- Valutazione del rischio di danno neuropsicologico per esposizione al piombo nell'infanzia
[Articolo su rivista]
Borella, Paola; N., Sturloni; Rovesti, Sergio; R., Vivoli; Bargellini, Annalisa; Vivoli, Gianfranco
abstract
Potential neurotoxicity of lead in children has been explored in many recent epidemiological studies carried out all over the world. Within a multicentric European study, an investigation was carried out also in Italy on children living in an industrial area and characterised by a non steady-state exposure condition with higher exposure at the early stages of life. This peculiar feature allowed to observe interesting associations between neurobehavioural functions and the levels of Pb measured in teeth, but not in blood. Indeed, Pb in teeth was associated with the results of psychometric tests which evaluate the discriminant ability and the attention. Other associations, like those found between the intelligence quotient (IQ) scores and Pb in teeth disappeared after correction for the socioeconomical status of parents. In general, in children exposed to environmental Pb, more consistent associations were found with visual-motor integration and attention than with IQ measurements. In agreement with literature data from other countries, we suggest that the relevance of neurotoxic effects of Pb is limited, at least at the current exposure levels, but also that a threshold Pb level associated with no effect cannot be identified
1997
- Inter-individual variability of benzene metabolism to trans-trans-muconic acid and its implications in the biological monitoring of occupational exposure
[Articolo su rivista]
Gobba, Fabriziomaria; Rovesti, Sergio; Borella, Paola; R., Vivoli; Caselgrandi, Eva; Vivoli, Gianfranco
abstract
Unmodified benzene (UBz) and trans,trans-muconic acid (t,t-MA) were measured in urine samples collected at the end of the first half-shift in 80 bus drivers from a large city in Northern Italy. Mean UBz was 1155 ng/l (S.D. = 494), range 85-1980 ng/l; these values roughly correspond to 10-1000 micrograms/m3 of benzene in air. Mean t,t-MA was 297 micrograms/g creatinine; the range was large (20-1295 micrograms/g creatinine), and the distribution of values was bimodal. At further analysis of t,t-MA data, two subgroups of 59 and 18 subjects were identified (3 outliers were excluded): mean values of the index were 108 (S.D. = 65) and 916 (S.D. = 264) micrograms/g creatinine respectively, and the values within each subgroup were normally distributed. The mean ratio between t,t-MA and UBz in the subgroups were 0.15 and 0.85, respectively; the difference was significant. The first subgroup was defined as 'poor t,t-MA metabolizers', the other as 'efficient t,t-MA metabolizers'. No inter-subgroup differences were observed regarding the main characteristics (age, dietary and smoking habits, etc.). As the parent compound of t,t-MA, trans,trans-muconaldehyde is myelotoxic, and its production has been implicated in benzene-induced leukemia. 'efficient' t,t-MA metabolizers may be at higher risk of developing benzene toxicity. If confirmed in further studies, the inter-individual variability rate of metabolizing benzene to t,t-MA may introduce some limitations in the application of this metabolite as an exposure index of low benzene exposure. Nevertheless, the t,t-MA/UBz ratio may be an important index of susceptibility to benzene toxicity.
1997
- OBSERVATIONS ON THE USE OF PLASMA, HAIR AND TISSUE TO EVALUATE TRACE ELEMENT STATUS IN CANCER
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; Caselgrandi, Eva; Piccinini, Lino
abstract
Selenium, zinc and copper were measured in plasma, hair and tissue of patients affected by either breast or lung cancer and their controls. A decrease in plasma Se and Zn in women affected by breast cancer was observed, whereas plasma Cu was increased in lung cancer. No significant modification was found in hair trace element levels adjusted for the main confounders, in particular for hair treatment which altered Se content. The examined elements were highly concentrated in cancerous vs normal tissue, but results changed according to the unit used to express results. The usefulness and significance of these biomarkers of trace element status are discussed in the light of the most recent literature data.
1997
- Personalità, stress psicologico e attività natural killer: studio preliminare
[Articolo su rivista]
Borella, Paola; BERNINI CARRI, E; Bargellini, Annalisa; Micaletti, E; Vivoli, R; Rovesti, Sergio
abstract
In questo studio preliminare vengono riportati i risultati di una indagine effettuata su giovani adulti per valutare se una situazione di stress psicologico, quale un esame di profitto, si accompagna ad alterazioni nella funzionalità del sistema immunitario, in particolare nella attività citolitica delle cellule natural killer (NK). Circa 300 cadetti del primo anno di corso della Accademia Militare di Modena sono stati sottoposti a una valutazione psicometrica per quantificare i tratti d’ansia della personalità e, su questa base, sono stati selezionati due gruppi di soggetti collocati agli estremi delle scale di valutazione. L’attività delle cellule NK è stata misurata, utilizzando una nuova metodica messa a punto nei nostri laboratori, prima dell’esame e, per confronto, in una giornata “tipo” all’inizio dell’anno accademico. L’attività NK è risultata inferiore negli allievi con un elevato punteggio di ansia di tratto, rispetto a quelli con un basso punteggio, e in occasione dell’esame rispetto alla giornata di controllo. Inoltre l’attività NK correlava con il punteggio di un questionario somministrato prima dell’esame, tendente a valutare l’ansia legata a questo evento stressante. È infine emersa una interessante relazione tra ansietà, risposta immunitaria e caratteristiche antropometriche, in quanto l’indice di massa corporea degli allievi correlava positivamente con l’attività NK e negativamente con il punteggio dell’ansia di stato.
1997
- Selenium status in the body of proliferative activity of malignant cells
[Articolo su rivista]
Piccinini, Lino; Borella, Paola; Bargellini, Annalisa
abstract
nd
1997
- Selenium, Zinc and Copper levels in blood, hair and tissue of patients affected by lung and breast cancer
[Abstract in Atti di Convegno]
Bargellini, Annalisa; Borella, Paola; Morandi, Uliano; Arigliano, V; Stefani, Alessandro; Fontana, I; Caselgrandi, E; Piccinini, L.
abstract
nd
1997
- Sorbitol dehydrogenase from bovine lens: Purification and properties
[Articolo su rivista]
Marini, I; Bucchioni, L; Borella, Paola; Del Corso, A; Mura, Umberto
abstract
Bovine lens sorbitol dehydrogenase (L-iditol:NAD(+) 2-oxidoreductase, EC 1.1.1.14) (SDH) was purified to electrophoretic homogeneity (51 U/mg of protein) and characterized for both kinetic and some structural properties. The enzyme proves to be a homotetramer of 156 kDa containing one equivalent of zinc ion per subunit. Metal chelators such as EDTA and 1,10-phenanthroline determine a loss of enzyme activity which can be specifically recovered by addition of either zinc or manganese ions. Inactivation induced not only by metal chelators but also by thiol reagents is effectively prevented by the pyridine cofactor. Bovine lens SDH is active on polyalcohols and keto-sugars with more than three carbon atoms, and also requires special steric constraints for substrate recognition. Of the polyols, xylitol is the most effective substrate (k(cat)/K-M of 8.1 s(-1) mM(-1)), followed by sorbitol (k(cat)/K-M of 1.59 s(-1) mM(-1)); fructose, the most effective carbonyl substrate, displays a k(cat)/K-M of only 0.9 s(-1) mM(-1). Analysis at the steady state of initial velocities as a function of the concentration of different substrates and cofactors and studies of product inhibition indicate for both fructose reduction and sorbitol oxidation a Theorell and Chance-type kinetic mechanism of action.
1997
- Studio caso-controllo dei tassi di Selenio (Se) nel sangue e nei tessuti di soggetti sani o affetti da tumore
[Poster]
Piccinini, L; Borella, Paola; Bargellini, Annalisa; Arigliano, V; Malavolta, L; Longo, L; Zoboli, A; Fontana, I; Morandi, Uliano; Stefani, Alessandro
abstract
nd
1997
- Trace element content of normal and cancerous lung and breast tissue
[Abstract in Atti di Convegno]
Piccinini, L; Borella, Paola; Bargellini, Annalisa; Morandi, Uliano; Arigliano, V; Stefani, Alessandro; Fontana, I.
abstract
nd
1996
- A case-control study on selenium, zinc, and copper in plasma and hair of subjects affected by breast and lung cancer
[Articolo su rivista]
Piccinini, Lino; Borella, Paola; Bargellini, Annalisa; C., Incerti Medici; A., Zoboli
abstract
The purpose of our study was to investigate the relationship between plasma and hair levels of Se, Zn, and Cu, and cancer. We selected a total of 66 patients affected by either breast (38) or lung (28) cancer. They entered into the study at the onset of disease, and before any chemical or radiotherapy. Controls were randomly selected among healthy people and were matched for sex, age, smoking habits, and residence. In the group of breast cancer, a significant decrease in hair Se was found compared to controls (p < 0.01), whereas plasma Se was only slightly decreased. No difference between cases and controls was detected in both hair and plasma levels of Zn and Cu. Subjects who developed lung cancer were significantly lower in hair Zn (p < 0.05) and Cu (p < 0.01) than controls, whereas there was no difference with regard to Se. In addition, plasma Cu of these patients was increased as compared to controls.
1996
- Chemical form of selenium greatly affects metal uptake and responses by cultured human lymphocytes
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; C., Incerti Medici
abstract
In this work, possible interference with functional activities of human lymphocytes after in vitro treatment with selenium was examined. Sodium selenite and selenomethionine compounds were tested in parallel, and their capability to inhibit or to increase the antibody production by lymphocytes was investigated. Furthermore, after incubation for 7 d, total cell-associated Se was measured by a fluorimetric method. The in vitro doses of Se employed in this study mainly reflect those measured in blood of individuals with different Se intake. Low doses of Se (0.5-2.0 mu M) added either as sodium selenite or selenomethionine did not alter the secretion of antibodies. When Se was added at higher levels, instead, an inhibitory effect was found using selenite, whereas a progressive increase in immunoglobulin production was observed after exposure to selenomethionine. Ln both cases, modifications were detected at 5 mu M (395 mu g Se/L), and were significant at 10 mu M (789 mu g Se/L). A different trend between the two chemical forms was also observed with regard to Se uptake by cells. Interestingly, both Se uptake and cell sensitivity were influenced by the density of the cells in culture. Our data suggest that the biological effects of Se in mammalian systems are strongly influenced by its chemical form, and caution should be exerted to avoid toxic effects of selenium.
1996
- L'educazione sanitaria nella formazione di base delle professioni sanitarie: il Diploma in Scienze Infermieristiche.
[Relazione in Atti di Convegno]
M., Triassi; Borella, Paola; P., Lombardo; D., Pagliacci
abstract
L'educazione sanitaria nella formazione di base delle professioni sanitarie: il Diploma in Scienze Infermieristiche.
1996
- Quality control in hair analysis: a systematic study on washing procedures for trace element determinations.
[Articolo su rivista]
Borella, Paola; Rovesti, Sergio; Caselgrandi, Eva; Bargellini, Annalisa
abstract
Trace element analysis of human hair is widely used to provide an indicator of body burden, but there is a major problem associated with preparation. The washing procedure adopted before analysis represents still a critical point which deserves particular attention. This study aimed at comparing the efficiency of the most commonly used washing methods to identify the procedure which allows for satisfactory removal of external contamination alone. As results depend strongly on the element, toxic (Cd and Pb), essential trace (Cr, Cu, Se and Zn) and major (Ca, K and Mg) elements were tested. The comparison was carried out with six different methods which include use of ionic and non-ionic detergents, organic solvents, chelating agents and sonication. Removal efficiency varied according to the element and pretreatment, the highest being observed for EDTA and the lowest for sonication. Unsatisfactory results were found using an acetone/methanol mixture for the potential contamination caused by it. Organic solvents showed the highest removal efficiency for K and toxic elements, and seemed to be effective in removing a limited but significant fraction of element incorporated in the lipid matter of hair. The ionic detergent Na lauryl sulphate, instead, was more effective for essential elements, but also triggered a higher analytic variability. As detergents appear to remove only external contamination, a non-ionic detergent such as Triton X-100 is proposed as a reliable alternative to the acetone method recommended by IAEA. Practical advantages are safe working conditions, rapidity of application and reduction in costs.
1996
- Test di autovalutazione. Igiene, Medicina Preventiva e Sanità Pubblica
[Monografia/Trattato scientifico]
Borella, Paola; Rovesti, Sergio
abstract
Contenuti: Metodologia epidemiologica. Demografia e statistiche sanitarie. Epidemiologia e profilassi generale delle malattie infettive. Epidemiologia e profilassi speciale delle malattie infettive e parassitarie. Epidemiologia e profilassi generale delle malattie non infettive. Epidemiologia e profilassi speciale delle malattie non infettive a eziologia multifattoriale. Fattori comportamentali e salute. Sanità pubblica: epidemiologia e prevenzione nelle varie età e fasi della vita. Igiene degli alimenti. L'acqua potabile. Inquinamenti ambientali e riflessi sulla salute. Legislazione e organizzazione sanitaria. Bibliografia.
1996
- Use of flameless atomic absorption spectroscopy in immune cytolysis for non radioactive determination of killer cell activity
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; S., Salvioli; Cossarizza, Andrea
abstract
We describe here a novel method to evaluate natural killer (NK) cytolytic activity by use of nameless atomic absorption spectroscopy (GF-AAS). This technique may be adopted for use in laboratories equipped with electrothermal atomic absorption spectrometers. Nonradioactive Cr as Na2CrO4 was used to label target cells (K562), and cell lysis was evaluated by measuring Cr released after 4 h of incubation with the effecters. We selected 520 mu g/L as the optimal dose for labeling targets, between 12 and 20 h as the optimal incubation time, and 10(4) cells as the optimal target size. Advantages of this method include: (a) exclusion of radioactive tracer, with no risk for workers; (b) limited costs; (c) high sensitivity and reproducibility; (d) possibility to store samples; and (e) better control of Cr used for labeling cells due to well-determined, fixed Cr concentrations in the range of nontoxic and linear cellular uptake. Comparison with data obtained by conventional Cr-51 labeling of targets killed by the same effecters was excellent, yielding comparable results and corroborating the method.
1995
- GENETIC-HETEROGENEITY IN TUBULAR HYPOMAGNESEMIA HYPOKALEMIA WITH HYPOCALCIURIA (GITELMAN'S SYNDROME)
[Articolo su rivista]
A., Bettinelli; M. G., Bianchetti; Borella, Paola; E., Volpini; M. G., Metta; E., Basilico; A., Selicorni; Bargellini, Annalisa; M. R., Grassi
abstract
To better clarify the genetic inheritance of primary tubular hypomagnesemia-hypokalemia with hypocalciuria, or Gitelman's syndrome (GS), we studied eight families (10 patients aged 11 to 22 years; 16 parents; 9 siblings) in which at least one offspring had GS (plasma magnesium < 0.65 mmol/liter; plasma potassium < 3.6 mmol/liter; high magnesium and potassium fractional excretions; molar urinary calcium/creatinine < 0.10). Two families each had two offspring of different sex with GS, who all had tetanic episodes and/or marked weakness during childhood or adolescence, whereas in three other families two mothers and three offspring presented GS and one father and two other offspring had hypomagnesemia and hypocalciuria but normal plasma potassium. The mean plasma magnesium and potassium levels of the patients of the first two families were significantly lower (P < 0.05) than those of the other three families. Intralymphocytic but not intraerythrocytic magnesium and potassium were significantly lower (P < 0.05) in patients compared to controls. We hypothesize that there are two different types of genetic transmission of GS, one autosomal recessive and one autosomal dominant with high phenotypic variability. It seems that this genetic heterogeneity is associated with a different clinical expression with frequent tetanic episodes and lower plasma potassium and magnesium levels in the autosomal recessive form.
1995
- L’AIDS pediatrico come problema di sanità pubblica: linee guida per medici e genitori
[Articolo su rivista]
Borella, Paola; Rovesti, Sergio; INCERTI MEDICI, C.
abstract
L’infezione da HIV in età pediatrica è particolarmente diffusa in Italia, prevalentemente a causa della trasmissione verticale da madri sieropositive. Ciò porta alla necessità di una informazione più accurata sul problema della trasmissione madre-figlio e alla incentivazione di campagne preventive indirizzate a sottogruppi di donne a rischio. Vengono qui riportate le più recenti acquisizioni sulle modalità di trasmissione verticale dell’HIV, sui fattori di rischio associati alla trasmissione e sulle norme di comportamento in caso di gravidanza a rischio, oltre a informazioni e consigli riguardo al problema dell’allattamento, delle vaccinazioni, della scolarizzazione dei bambini nati da madre sieropositiva.
1995
- THE USE OF NONRADIOACTIVE CHROMIUM AS AN ALTERNATIVE TO CR-51 IN NK ASSAY
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; Salvioli, S; INCERTI MEDICI, C; Cossarizza, Andrea
abstract
A novel method to measure target cell cytolysis based on the use of 'cold', non-radioactive chromium and on the determination of metal release by graphite furnace atomic absorption spectroscopy (FAAS) is proposed. Natural killer (NK) assays were performed by labelling target cells with chromium as Na2CrO4, and results were compared with those obtained by conventional overnight labelling with Cr-51 of targets killed by the same effecters. The cytotoxic capacity of peripheral blood lymphocytes from healthy subjects was evaluated, and NK activity measured with both methods showed a good agreement at each of the tested effector to target cell ratios (between 100:1 and 1:1), with a high and significant coefficient of correlation (r = 0.931, p < 0.0001). The selection of the appropriate Cr concentrations for labelling target cells took into account both the sensitivity of our instrumentation and the possible toxic effects of the metal. A study of the effects of Cr on the cell line (K562) which is usually employed as a target in NK tests showed that Cr could have a detrimental effect on cellular function, with significant numbers of cells with depolarised mitochondria and reduced DNA synthesis after 24 h incubation using Cr levels higher than 15 mu mol/l (780 mu g/l). The method proposed here has a number of advantages, including the use of a non-radioactive tracer, limited costs, high sensitivity and reproducibility, and the possibility of storing samples. In addition, the technique uses a fixed Cr concentration which is known to be non toxic.
1994
- Effect of different exercises on plasma and erythrocite magnesium concentrations.
[Articolo su rivista]
Becchi, Maria Angela; Borella, P.
abstract
We studied 10 male runners before and after a maximal test on a bicycle ergometer, 5 male swimmers before and after one our swimming and 8 male basketball players before and after a basket match to compare plasma volume, plasma and erythrocite magnesium changes during different exercises. Both plasma and erythrocite magnesium decreased significantly less during maximal test than during swimming and basketball, confirming the role of the duration rather the intensity of exercose.
1994
- Effects of Mg pyrrolidone carboxylate treatment in Gitelman's syndrome
[Relazione in Atti di Convegno]
A., Bettinelli; Borella, Paola; M. G., Metta; E., Basilico; E., Volpini; C., Santeramo; Bargellini, Annalisa
abstract
The results of this study seem to indicate the use of magnesium pyrrolidone carboxylate in the treatment of Gitelman' syndrome
1994
- Intracellular magnesium is reduced in patients at risk for developing pregnancy-induced hypertension
[Relazione in Atti di Convegno]
C., Battaglia; Borella, Paola; F., Pianazzi; S., De Martis; F., Droghini; Facchinetti, Fabio
abstract
The aim of the present study was to correlate the maternal Mg levels with increased resistance of uterine arteries, in patients at risk of developing PIH.
1994
- Magnesium supplementation in adults with marginal deficiency: response in blood indices, urine and saliva
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa; G., Ambrosini
abstract
Magnesium in plasma, erythrocyte, urine and saliva was measured before intervention, and at weekly intervals during two 28-d cycles of Mg supplementation in a group of 10 adults with marginal Mg deficiency (mean daily intake = 3.58 mg/kg). A group of untreated subjects with higher Mg intake (4.51 mg/kg) served as control. Urinary Mg excretion was correlated with Mg intake, and increased significantly by treatment. No difference was ascertained in plasma, except in subjects with the lowest Mg intake. Mg in erythrocytes was 10% lower in the deficient group, and reached values close to controls after 2 weeks of supplementation. Modifications in salivary Mg were also detected. The significance and usefulness of each index for clinical purpose are discussed.
1994
- Possibile ingestione di cadmio e piombo tramite consumo di funghi freschi del commercio
[Articolo su rivista]
Borella, Paola; E., Caselgrandi; Fabio, Giuliana; C., Gibertoni
abstract
.
1994
- Recommendations about the use of leucocytes to assess magnesium status
[Relazione in Atti di Convegno]
Borella, Paola; Facchinetti, Fabio; E., Rocchi; R., Lorini; Bargellini, Annalisa
abstract
The results of this study suggest that leucocytes are suitable for detecting magnesium deficiency, although modifications in magnesium content may differ according to the population studied.
1994
- TRACE ELEMENTS IN SALIVA AND DENTAL CARIES IN YOUNG ADULTS
[Articolo su rivista]
Borella, Paola; Fantuzzi, Guglielmina; Aggazzotti, Gabriella
abstract
The results of a study on Zn, Cu, Ca and Mg content in whole saliva and supernatant of young adults in relation to caries prevalence are reported. A total of 225 university students were selected for the study on the basis of voluntary participation. The salivary electrolytes showed a high intersubjective variability and females had significantly lower levels than males. In whole saliva, the trace elements were highly correlated, whereas the correlations were weaker in the supernatant. The ratio supernatant/whole saliva varied between subjects and ar-cording to the examined electrolytes. No association could be found between the measured trace elements and DMFT. When we analysed the relation with recent caries experience in the subgroup of subjects undergoing oral examinations for at least 1 year, we found evidence that the Zn/Cu molar ratios in whole saliva were significantly decreased in subjects with more than three decayed teeth compared with those with no caries (1.54 vs. 1.11, P < 0.05). No significant association was found when supernatant was analysed. We conclude that the electrolytes' levels in whole saliva might be more adequate than the levels in supernatant to evaluate the relationship with caries.
1994
- Zinc and magnesium in liver cirrhosis
[Articolo su rivista]
Rocchi, E.; Borella, Paola; Borghi, A.; Paolillo, F.; Pradelli, M.; Farina, F.; Caselgrandi, G.
abstract
.
1993
- Associazione tra alcune abitudini alimentari, igiene orale e carie dentale in giovani adulti
[Articolo su rivista]
Borella, Paola; Fantuzzi, Guglielmina; Aggazzotti, Gabriella
abstract
.
1993
- Correlazioni tra magnesio intra cellulare e variazioni pressorie circadiane in gravidanza
[Relazione in Atti di Convegno]
Facchinetti, Fabio; F., Pianazzi; Borella, Paola; S., De Martis; Bargellini, Annalisa; A. R., Genazzani
abstract
In questo studio preliminare abbiamo voluto verificare le possibili correlazioni tra omeostasi del Mg e variazioni circadiane della pressione arteriosa. Sono state studiate, alla 20a settimana di gestazione, 8 gravide che presentavano fattori di rischio per lo sviluppo di PIH
1993
- EFFECTS OF TRACE-ELEMENTS ON IMMUNE-SYSTEM - RESULTS IN CULTURED HUMAN-LYMPHOCYTES
[Articolo su rivista]
Borella, Paola; Bargellini, Annalisa
abstract
We have studied the effects of lead, cadmium and hexavalent chromium in cultured human lymphocytes. Both the proliferative response and the generation of antibodies were evaluated, and the metal accumulation in the cells was measured. Lead added in the range of human exposure caused a significant enhancement in Ig production, which was related to the Pb concentration in the cells. An inhibitory effect on blastogenesis, was detected at Cd doses found in occupationally exposed subjects. Chromium induced reductions in both blastogenesis and Ig production in relation to its capability to enter the cells.
1993
- Is magnesium content in erythrocytes suitable for evaluating cation retention after oral physiological supplementation in marginally magnesium-deficient subjects?
[Articolo su rivista]
Borella, Paola; G., Ambrosini; M., Concari; Bargellini, Annalisa
abstract
In this study, the effects of oral magnesium supplementation were evaluated on plasma, erythrocyte, and urinary cation levels. The study was carried out with an open, cross-over and randomized design. Healthy subjects received two sachets per day of magnesium (366 mg Mg2+/d) for two 28 d cycles, separated by a 3-week washout interval. Magnesium concentrations were measured before the supplementation and at weekly intervals during the treatment. Urinary excretion of Mg was significantly increased during supplementation, with no differences among the weeks examined. Only small increases in plasma magnesium occurred, and values returned to the prestudy levels before the end of supplementation. The increase in erythrocyte magnesium, however, was statistically significant; this trend suggests the existence of a saturable mechanisms, which prevents any possible magnesium overload during oral supplementation. We conclude that erythrocytes might be considered a suitable index for evaluating the bioavailability of magnesium salts in marginally magnesium-deficient subjects
1992
- Evaluation of intracellular magnesium in health and disease
[Relazione in Atti di Convegno]
Borella, Paola; M., Concari
abstract
-
1992
- Oral magnesium supplementation improves fetal circulation.
[Articolo su rivista]
Facchinetti, Fabio; C., Battaglia; R., Benatti; Borella, Paola; A. R., Genazzani
abstract
It is well known that pregnancy is a condition in which plasma magnesium falls because of accumulation of the ion in the placenta and fetus. Magnesium (Mg) is therefore widely given as a supplement during pregnancy, particularly in cases of preterm labour. In our experience, the combination of oral Mg (magnesium pyrrolidone carboxylic acid) at a dose of 360 mg/day with conventional ritodrine treatment allows a reduction in ritodrine dosage, accompanied by a significant reduction in side effects. We therefore evaluated changes in fetal blood flow, using pulsed Doppler, in women submitted to combined magnesium and ritodrine treatment compared to those treated with ritodrine plus placebo. The Mg-treated group showed a decrease in vessel resistance both in the umbilical artery and in the fetal middle cerebral artery, indicating that fetal vasculature is sensitive to exogenous Mg. Measurement of plasma and mononuclear cell Mg showed an intracellular increase in the cation of about 10 per cent. We conclude that oral magnesium supplementation in pregnancy is safe and that it has a positive effect on the fetal circulation.
1991
- I funghi accumulano cadmio, rame e piombo in concentrazioni significative
[Articolo su rivista]
Borella, Paola; Quaglio, Giampaola; E., Caselgrandi; M., Cassinadri
abstract
-
1991
- Lead and cadmium at very low doses affect in vitro immune response of human lynphocytes
[Articolo su rivista]
Borella, Paola; A., Giardino
abstract
The effect of lead chloride and cadmium chloride on in vitro immunoglobulin (Ig) production by human lymphocytes was investigated. After 7 days in culture, lead added in the range of human exposure (207-1035 micrograms/liter) significantly enhanced Ig production either when cells were activated by pokeweed mitogen (PWM) or not. The effect was dose-dependent and was related to the Pb we measured in the extracellular medium and in the cells. Independently of the mitogen addition, about 2% of the Pb added was accumulated in the cells, most being associated with the nuclear fraction. Those findings suggest that the Pb effects could depend on its uptake and distribution in the cells. Cadmium added in the 50-500 nM range exhibited a dose-independent mitogenic activity in unstimulated cells, whereas the Ig secretion was not significantly affected by Cd when cells were PWM-activated. A considerable intraindividual variability, however, was observed when blood donors were separately examined, with both an increase, a decrease, or no variation on Ig production. Furthermore, higher percentages of Cd were accumulated in the nuclear fraction, and lower in the cytosol and precipitate, in PWM-activated compared to resting lymphocytes. Genetic factors could be of importance for the observed variability of the immune response to cadmium, and we support the hypothesis that differences in the metallothionein (MT) inducibility could play a role.
1991
- Magnesium in aging and dementia
[Relazione in Atti di Convegno]
Borella, Paola; A., Giardino; Neri, Mirco; E., Andermarcher
abstract
In this study, we evaluated the magnesium status in a group of elderly people with and without dementia of the Alzheimer's type, and the results have been compared with those obteined in a control group of healthy younger subjects.
1991
- Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium.
[Articolo su rivista]
Facchinetti, Fabio; G., Sances; Borella, Paola; A. R., Genazzani; G., Nappi
abstract
The effects of oral Magnesium (Mg) pyrrolidone carboxylic acid were evaluated in 20 patients affected by menstrual migraine, in a double-blind, placebo controlled study. After a two cycles run-in period, the treatment (360 mg/day of Mg or placebo) started on the 15th day of the cycle and continued till the next menses, for two months. Oral Mg was then supplemented in an open design for the next two months. At the 2nd month, the Pain Total Index was decreased by both Placebo and Mg, with patients receiving active drug showing the lowest values (P less than 0.03). The number of days with headache was reduced only in the patients on active drug. Mg treatment also improved premenstrual complaints, as demonstrated by the significant reduction of Menstrual Distress Questionnaire (MDQ) scores. The reduction of PTI and MDQ scores was observed also at the 4th month of treatment, when Mg was supplemented in all the patients. Intracellular Mg++ levels in patients with menstrual migraine were reduced compared to controls. During oral Mg treatment, the Mg++ content of Lymphocytes (LC) and Polymorphonucleated cells (PMN) significantly increased, while no changes in plasma or Red Blood Cells were found. An inverse correlation between PTI and Mg++ content in PMN was demonstrated. These data point to magnesium supplementation as a further means for menstrual migraine prophylaxis, and support the possibility that a lower migraine threshold could be related to magnesium deficiency
1991
- Oral magnesium successfully relieves premenstrual mood changes
[Articolo su rivista]
Facchinetti, Fabio; Borella, Paola; G., Sances; L., Fioroni; R. E., Nappi; A. R., Genazzani
abstract
Reduced magnesium (Mg) levels have been reported in women affected by premenstrual syndrome (PMS). To evaluate the effects of an oral Mg preparation on premenstrual symptoms, we studied, by a double-blind, randomized design, 32 women (24-39 years old) with PMS confirmed by the Moos Menstrual Distress Questionnaire. After 2 months of baseline recording, the subjects were randomly assigned to placebo or Mg for two cycles. In the next two cycles, both groups received Mg. Magnesium pyrrolidone carboxylic acid (360 mg Mg) or placebo was administered three times a day, from the 15th day of the menstrual cycle to the onset of menstrual flow. Blood samples for Mg measurement were drawn premenstrually, during the baseline period, and in the second and fourth months of treatment. The Menstrual Distress Questionnaire score of the cluster "pain" was significantly reduced during the second month in both groups, whereas Mg treatment significantly affected both the total Menstrual Distress Questionnaire score and the cluster "negative affect." In the second month, the women assigned to treatment showed a significant increase in Mg in lymphocytes and polymorphonuclear cells, whereas no changes were observed in plasma and erythrocytes. These data indicate that Mg supplementation could represent an effective treatment of premenstrual symptoms related to mood changes
1990
- Cadmium, nickel, chromium and lead accumulate in human lymphocytes and interfere with PHA-induced proliferation
[Articolo su rivista]
Borella, Paola; S., Manni; A., Giardino
abstract
The in vitro effect of five toxic metals (cadmium, lead, nickel, barium, chromium III and VI) on PHA-induced blastogenesis in human lymphocytes was investigated by [3H]-thymidine incorporation. With the exception of hexavalent chromium, the metals tested were in the chloride forms. The levels of metals associated with lymphocytes were measured under our experimental procedure. An inhibitory effect was found when cadmium was added at doses which closely approximate those of occupationally exposed subjects. Hexavalent chromium and nickel showed a biphasic pattern, with a stimulatory effect at the lowest concentrations tested (10(-8)-10(-6) mol/L) and an inhibitory effect on thymidine incorporation at concentrations higher than 10(-6) and 10(-4) mol/L, respectively. No effect was observed when lead, barium, and trivalent chromium were added to the culture medium. All metals showed the ability to enter the lymphocytes or to adhere to their surface, and the interaction appeared to be quite stable, with the exception of barium. The relationship between metal accumulation and [3H]-thymidine incorporation in the cells is discussed
1990
- Magnesium and potassium status in elderly subjects with and without dementia of the Alzheimer type.
[Articolo su rivista]
Borella, Paola; A., Giardino; Neri, Mirco; E., Andermarker
abstract
Magnesium status was evaluated in healthy elderly people, and in patients affected from dementia of the Alzheimer type. Magnesium levels were determined in plasma, erythrocytes (RBC), lymphocytes (MNC), and granulocytes (PMN), and were compared with measurements in young healthy adults. Significantly lower plasma Mg concentrations were found in elderly people compared to controls, with no difference between cognitively normal and demented subjects. Mg levels in healthy elderly people were higher in MNC and lower in PMN, compared to the younger group. No difference was observed between demented patients and young controls in Mg content of white blood cells, but the patients had higher Mg/K ratios. In addition, significant correlations were found between cognitive impairment and the Mg/K ratio in MNC. When we assessed the philothermal response of granulocytes, a significant correlation was observed in demented subjects between the migration rate of PMNs and the PMN Mg/K ratio.
1990
- Maternal plasma concentration of magnesium, calcium, zinc and copper in normal and patological pregnancies
[Articolo su rivista]
Borella, Paola; A., Szilagyi; G., Than; I., Csaba; A., Giardino; Facchinetti, Fabio
abstract
In this study, plasma levels of magnesium, calcium, zinc and copper were simultaneously determined in pregnancies complicated by either abortion, intrauterine growth retardation (IUGR), diabetes or EPH (edema, proteinuria, hypertension) gestosis. The levels of the four cations in non-pregnant women and in healthy, pregnant women were also determined. Compared with controls, a significant decrease in magnesium, with increase of the Ca/Mg ratio, was found in spontaneous abortions, but not when patients had a successful continuation of pregnancy. In EPH gestosis, total calcium was reduced, with a significant decrease of the plasma Ca/Mg ratio. A slight, but significant, increase in plasma zinc was observed in women affected by either diabetes or IUGR, probably as a result of reduced zinc uptake by the fetus. In addition, higher copper levels were found in the pathologies studied, with the exception of missed abortions. The possible role of an altered Ca/Mg ratio homeostasis in relation to gestational pathologies is discussed.
1990
- Reduction of monocyte magnesium in patients affected by premenstrual-syndrome.
[Articolo su rivista]
Facchinetti, Fabio; Borella, Paola; L., Fioroni; T., Pironti; A. R., Genazzani
abstract
.
1989
- A nutrition survey of a group of athletes with particular reference to magnesium, zinc and copper intake, and to the relative intra- and extra-cellular levels
[Articolo su rivista]
Borella, P.; Sala, F.; Giardino, A.
abstract
The aim of the present study was to evaluate the dietary habits in a group of athletes (footballers) compared with sedentary subjects matched for sex, age and body mass index. All subjects kept a record of food eaten for seven consecutive days using various models for portion sizes. Daily nutrient intake was then computed and was expressed as either total intake, or percent of the recommended daily dietary allowances (LARN). For each subject, a 20-ml blood sample and a 24h urine sample was collected for analysis of magnesium, zinc and copper. The three elements were measured both in plasma and in erythrocytes, monocytes and neutrophils. The athletes eat significantly more sheets than controls (22.5% of total kcal vs 15.2%, p less than 0.01) and significantly less cereals (22.5% vs 31.7%, p less than 0.01). Concerning the nutrient composition, in both groups the lipid intake was higher than that recommended and this trend was more pronounced in the athletes (+ 43.2% vs + 16.1% in the controls). In addition, the diet was particularly rich in animal fats with a mean intake of 21.0% of total kcal in the athletes and 20.9% in the sedentary group (recommended value was 12.5% and 14%, respectively). A parallel reduction in vegetal protein intake was observed in the trained group, and the difference was significant (4.3% of kcal in the athletes and 5.2% in the controls, p less than 0.01). Furthermore, in the athletes the soluble carbohydrate intake was higher than the recommended levels (+ 110%) and significantly higher than that eaten by the controls (21.0% vs 16.4% of kcal, p less than 0.01), with parallel decrease of polysaccharides intake.(ABSTRACT TRUNCATED AT 250 WORDS)
1989
- Blood, teeth and hair: 3 different materials used to evaluate exposure to lead and cadmium in children living in an industrial zone
[Articolo su rivista]
Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina
abstract
There is a general agreement that children are a population at increased risk with respect to lead and cadmium exposure and to adverse health effects resulting from increased exposure. Different biological indicators such as blood hair and teeth have been used to evaluate lead and cadmium exposure in humans. However, up to date, it has not been established which is the best indicator to provide an assessment of internal exposure. The aim of the present study was to examine the levels of lead and cadmium in hair, blood and teeth of children living from birth in an industrialized area near Modena. The relationship between these indicators of exposure and children characteristics such as sex, weight, height, blood pressure and smoking habits of parents was also examined. 142 children (71 males and 71 females) representing 20.8% of those aged 6-7 years living in Sassuolo (Modena) have been included in the study. The geometric means of lead in blood, hair and teeth were 11.2 micrograms/dl, 7.24 micrograms/g and 6.16 micrograms/g, respectively. Hair lead were significantly related to both blood and teeth values (r = 0.226, p = 0.007 and r = 0.186, p = 0.027, respectively). Mean cadmium concentrations were 0.47 mu/l in blood, 0.17 micrograms/g in hair and 47.9 ng/g in teeth and no significant correlation was observed between the three biological matrixes examined. Significant correlations were found between lead and cadmium in both hair (r = 0.427, p = 0.000) and teeth (r = 0.224, p = 0.007). In addition, for lead content in teeth, a significant difference between boys and girls was observed; females showed higher values than males (6.77 micrograms/g vs 5.61 micrograms/g; t = 2.23 p = 0.028). Taking into account the individual characteristics of children, a negative relationship was found between Pb levels in teeth and height (r = -0.217, p = 0.024). Systolic blood pressure values were positively associated to cadmium hair levels in males but not in females (r = 0.281; p = 0.053). From the results of the present study it appears that blood, hair and teeth provide different information to predict lead and cadmium exposure of children. Hair seem to be a useful global indicator of total environmental pollution.
1989
- Cadmium in blood, urine and hair related to human hypertension
[Articolo su rivista]
G., Vivoli; Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina; E., Caselgrandi
abstract
A case-control study was performed to assess whether cadmium is related to hypertension in a non-occupationally exposed population. 63 male subjects affected by mild stable hypertension, pharmacologically untreated, were investigated together with 63 male normotensive controls individually matched for sex, age, body mass index, smoking habits and work activities. Cadmium in blood, zinc and copper in serum, the three elements in urine and hair, together with some biological parameters involved in pathogenesis of hypertension, were investigated. The mean Cd blood value in hypertensives (H) was 0.58 micrograms/L vs 0.44 micrograms/L in normotensives (N) (t = 2.03; p less than 0.05) with a greater difference in non-smokers (0.41 micrograms/L vs 0.25 micrograms/L) (t = 2.69, p less than 0.01). Furthermore, both systolic and diastolic blood pressure were significantly related to cadmium blood levels (r = 0.20 and 0.19 respectively, p less than 0.05). Smoking habit affected cadmium levels only in the blood, not in the other biological matrices examined. No significant difference of cadmium content in urine and hair was found between normotensives and hypertensives but Cd/Cu ratio in urine was significantly lowered in the second group
1989
- Indagine alimentare in un gruppo di sportivi con particolare riferimento agli introiti di magnesio, zinco e rame ed ai relativi livelli intra ed extracellulari
[Articolo su rivista]
Borella, Paola; F., Sala; A., Giardino
abstract
The aim of the present study was to evaluate the dietary habits in a group of athletes (footballers) compared with sedentary subjects matched for sex, age and body mass index. All subjects kept a record of food eaten for seven consecutive days using various models for portion sizes. Daily nutrient intake was then computed and was expressed as either total intake, or percent of the recommended daily dietary allowances (LARN). For each subject, a 20-ml blood sample and a 24h urine sample was collected for analysis of magnesium, zinc and copper. The three elements were measured both in plasma and in erythrocytes, monocytes and neutrophils. The athletes eat significantly more sheets than controls (22.5% of total kcal vs 15.2%, p less than 0.01) and significantly less cereals (22.5% vs 31.7%, p less than 0.01). Concerning the nutrient composition, in both groups the lipid intake was higher than that recommended and this trend was more pronounced in the athletes (+ 43.2% vs + 16.1% in the controls). In addition, the diet was particularly rich in animal fats with a mean intake of 21.0% of total kcal in the athletes and 20.9% in the sedentary group (recommended value was 12.5% and 14%, respectively). A parallel reduction in vegetal protein intake was observed in the trained group, and the difference was significant (4.3% of kcal in the athletes and 5.2% in the controls, p less than 0.01). Furthermore, in the athletes the soluble carbohydrate intake was higher than the recommended levels (+ 110%) and significantly higher than that eaten by the controls (21.0% vs 16.4% of kcal, p less than 0.01), with parallel decrease of polysaccharides intake.
1989
- Intra-uterine growth retardation is associated with increased levels of magnesium in amniotic fluid.
[Articolo su rivista]
Facchinetti, Fabio; Borella, Paola; M., Valentini; A., Segre; C., Battaglia; A. R., Genazzani
abstract
Magnesium (Mg) and zinc (Zn) levels were measured in amniotic fluid of 30 normal pregnancies between the 16th and the 42nd week of amenorrhea and in 15 cases of intra-uterine growth retardation (IUGR) at 30-38th week of pregnancy. While Zn levels were stable throughout physiological pregnancy, the Mg concentration decreased progressively from 1.09 +/- 0.31 mg/100 ml (mean +/- SD) at the end of the second trimester to 0.75 +/- 0.20 (p less than 0.02) at term. In the case of IUGR, Mg levels (1.22 +/- 0.28) were higher than in controls (0.89 +/- 0.27, p less than 0.01) matched for gestational age. No differences in Zn levels were found between the two groups. Although the mechanisms leading to Mg accumulation in the amniotic fluid of growth-retarded fetuses remain unknown, these data support the role played by Mg in fetal growth.
1989
- Relationship between lead exposure indicators and neuropsychological performance in children
[Articolo su rivista]
Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina; Vivoli, Gianfranco; Sturloni, Nicoletta; Cavazzuti, Giovanni Battista; Tampieri, Auro; Pl, Tartoni
abstract
This study surveyed 237 schoolchildren in a lead-polluted industriaI area in northern Italy to assess the relationship between various biological indicators (lead in blood, hair and teeth, and deltaaminolevulinic dehydratase [ALA-D] activity) and some neuropsychological functions, assessed by a battery of five psychometric tests. The geometric means of lead measured in blood, hair and teeth were 1O.99 ug/dl, 6.79 ug/g and 6.05 ug/g, respectively. Mean ALA-D activity was 5l mU/mi RBC. By analysis of covariance, after regressing out the variance accountable to confounding variables (age, sex, occupation/education of parents), Total and Verbal WISC-R IQ and Toulouse Pieron test results were significantly affected by the levels of lead in teeth. ALA-D values also appeared to be related to WISC-R IQ results (Total, Verbal and Performance).
1989
- Tissue magnesium status in patients with chronic liver disease
[Relazione in Atti di Convegno]
Borella, Paola; Ferrari, Angela; S., Scaduti; P. L., Tartoni
abstract
The aim of this study was to determine Mg in erythrocytes in mononuclear cells and polymorphonuclear cells from patients with CL, both alcoholics and non-alcoholics and in a control healthy group.
1989
- Variazioni plasmatiche di magnesio, zinco e rame a seguito di ripetuti impegni agonistici di squadra (pallacanestro).
[Articolo su rivista]
Becchi, Maria Angela; Zuliani, U.; Borella, P.; Zorandi, A.; Bargossi, A.; Lubich, T.
abstract
E' stato valutato l'andamento dei livelli plasmatici di Mg, Zn, e Cu su 9 giocatori di pallacanestro in occasione di 3 incontri effettuati a distanza di pochi giorni. Soli il Mg ha evidenziato riduzioni significative, rendendo giustificata la somministrazione di supplementi
1988
- Il consumo di caffè in gravidanza si associa a ridotti livelli ematici di zinco e calcio
[Articolo su rivista]
Borella, Paola; Polmonari, G; Rovesti, Sergio
abstract
In questo studio è stato valutato il rapporto tra consumo di caffé in gravidanza e livelli ematici di alcuni elementi essenziali (zinco, rame, calcio, magnesio e ferro), nelle madri e nei rispettivi neonati. È emersa una significativa riduzione della concentrazione plasmatica ed eritrocitaria di zinco in rapporto all’assunzione di questa bevanda solo nel sangue materno, mentre nel sangue del funicolo il calcio era significativamente e progressivamente ridotto all’aumentare del numero di tazze di caffé bevute giornalmente dalle madri. Dai risultati di questo studio, gli AA ritengono di avanzare la proposta di una limitazione all’assunzione di caffé durante il periodo gestazionale.
1988
- Premenstrual increase of intracellular magnesium levels in women with ovulatory, asymptomatic menstrual cycles
[Articolo su rivista]
Facchinetti, Fabio; Borella, Paola; M., Valentini; L., Fioroni; A. R., Genazzani
abstract
Intracellular magnesium (Mg) levels regulate several enzymatic reactions and the hypoactivity of Mg has been involved in different pathological states. In addition to other factors, gonadal hormones, too, have been found to interfere in Mg balance. This study evaluates the changes in Mg in women throughout the normal menstrual cycle and those measured at weekly intervals in males. Magnesium and potassium (K) levels were measured in the plasma, red blood cells (RBC), lymphocytes (LC) and polymorphonucleated cells (PMN) of 11 normal menstruating women, in different periods of their menstrual cycle. Blood samples were collected every 4th day. According to the time and LH, progesterone and estradiol levels, they were classed as follicular (Foll), periovulatory (OV), luteal (Lut) or premenstrual (PM). The Menstrual Distress Questionnaire completed by the subjects revealed that no significant symptomatology was present. Four blood samples were also collected from 4 normal males, at weekly intervals. Mg and K were determined by atomic absorption spectrophotometry. LC and PMN were purified by centrifugation on a Ficoll discontinuous gradient. No differences were found in males versus females in the Mg or K contents in the different compartments. In the 4 periods tested, the K levels were constant, in both females and males. The same applies for Mg contents in males. In females, Mg contents, as well as the Mg/K ratio in LC and PMN, showed a significant increase in the premenstrual period compared with the other periods of the cycle. On the contrary, plasma and RBC Mg levels were constant throughout the cycle
1988
- Variazione plasmatica di magnesio, rame e zinco a seguito di impegno muscolare strenuo do breve durata
[Articolo su rivista]
Becchi, Maria Angela; Borella, P.; Michelini, N.
abstract
14 soggetti maschi praticanti attività sportiva agonistica sono stati sottoposti ad una prova da sforzo massimale al cicloergometro al fine di valutare le modificazioni plasmatiche di Mg, Cu e Zn.A seguito dell'esercizio sono stati evidenziati significativi aumenti dell'ematocrito, e dei livelli plasmatici degli elettroliti. Applicando le correzioni (quoziente di van Beaumont) per eliminare l'effetto della contrazione del volume plasmatico sugli aumneti degli elettroliti, solo il Mg ha mostrato una riduzione altamente significativa, effetto di shift inter-compartimentali o di stato carenziale latente.
1987
- Cadmium levels in tooth, hair, blood of children
[Relazione in Atti di Convegno]
Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina; Tartoni, Pier Luigi; Vivoli, Gianfranco
abstract
-
1987
- Cadmium, zinc, and copper in hypertension
[Relazione in Atti di Convegno]
Borella, Paola; Bergomi, Margherita; Fantuzzi, Guglielmina; Rovesti, Sergio; Vivoli, Gianfranco
abstract
Cadmium, zinc and copper levels in blood, hair and urine were measured in hypertensives and matched normotensives. A significant increase of cadmium in blood was found in relation to hypertension, particularly when subjects were non smokers. Furthermore, cadmium levels in blood and the ratio Cd/Zn in blood and urine appeared to be significantly and positively related to both systolic and diastolic blood pressure levels. Copper excretion in urine of hypertensives and normotensives was 14.1 and 9.2 µg/g creat., respectively, and the difference was statistically significant. As far as zinc-dependent enzymes were concerned, alkaline phosphatase activity was significantly lower in both untreated and treated hypertensives compared with their controls.
1987
- Zinc and copper levels in serum, urine and hair of humans in relation to blood pressure
[Articolo su rivista]
G., Vivoli; Borella, Paola; Bergomi, Margherita; Fantuzzi, Guglielmina
abstract
Zinc and copper status was evaluated in 63 early hypertensives and compared with that of 63 normotensives matched for sex, age, smoking habits and body mass index. Zinc and copper in serum, urine and hair were measured, and the serum activity of two zinc-dependent enzymes (AP and LDH) were analysed. Mean urinary copper concentration in patients was 14.11 micrograms g-1 creatinine compared with 9.16 micrograms g-1 creatinine in normotensive subjects (paired "t" = 3.94, p less than 0.001). Serum AP and LDH were significantly decreased (16 and 36%, respectively) in the patients compared with controls, although almost all values fell within the normal range of activities. Systolic and diastolic pressures were significantly and positively correlated to urinary copper excretion. These correlations were still apparent after correcting blood pressure values for other urinary measurements. Blood pressure levels (both systolic and diastolic) were also negatively correlated with the two zinc-dependent enzymes.
1986
- Lead content in abortion material from urban women in early pregnancy
[Articolo su rivista]
Borella, Paola; P., Picco; G., Masellis
abstract
Lead concentration was determined in abortion material obtained from non-professionally exposed women following legal abortions. Furthermore, lead and free erythrocyte porphyrin levels in mother's blood were measured. Under conditions of apparent "normal" lead exposure, we detected lead levels in abortion products which were between 0.07 and 5.29 micrograms/g dry weight with a geometric mean of 1.27. No significant correlation was observed between the parameters measured in mother's blood and lead content in the specimens of the first trimester. The influence of different factors, such as smoking, area of residence, gestational age and parity, was also investigated. None of these factors showed a contributory effect on the total variation of lead in abortion material. From these data, we can conclude that, at least in our population, lead does not accumulate in human embryos/fetuses in the first trimester of pregnancy.
1985
- Cadmium distribution in some biological matrixes in hypertension: a case- control study
[Relazione in Atti di Convegno]
Vivoli, Gianfranco; Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina; E., Caselgrandi; A., Fusco; M., Tamburi
abstract
-
1985
- Distribution of lead in the blood and hair of a children population residing in an industrial area
[Articolo su rivista]
Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina; Vivoli, Gianfranco
abstract
.
1985
- Mobilizzazione sperimentale ad opera dell'NTA dei metalli presenti in sedimenti fluviali prelevati nella Provincia di Modena
[Articolo su rivista]
Borella, Paola; Predieri, Guerrino
abstract
Mobilizzazione sperimentale ad opera dell'NTA dei metalli presenti in sedimenti fluviali prelevati nella Provincia di Modena
1985
- Neurobehavioral and neurochemical abnormalities of pre- and postnatally lead-exposed rats: zinc, copper and calcium status.
[Articolo su rivista]
Baraldi, Mario; P., Zanoli; Rossi, Tiziana; Borella, Paola; E., Caselgrandi; F., Petraglia
abstract
Although diverging opinions have been expressed, there is a body of evidence of a cause-effect relationship between chronic exposure to lead and altered behavior in children. There are several problems in the interpretation of the behavioral and biochemical anomalies described in experimental models of lead intoxication due mainly to the different experimental conditions used. One of the major criticisms is linked with the claim that in several studies too high levels of exposure were used, hence inducing the suspicion that the effects specifically attributed to lead intoxication could be related to unspecific actions. Here we report that, using an experimental model of pre- and postnatal intoxication of rats exposed to a very low amount of lead (1 mg/kg/day), in parallel with behavioral anomalies, there are slight changes in cerebral dopaminergic and GABAergic receptors. A new finding was the discovery that in this condition there is a markedly increased number of opiate receptors in the hypothalamus (and other brain areas) in parallel with a decrease of beta-endorphin and an increase of Met-enkephalin. Therefore, low levels of lead intoxication which could be pertinent to the human situation, seem to induce neurotoxic effects which may be responsible for the behavioral anomalies in rats and, maybe, in children.
1985
- Study of biological indicators related to early effects of lead on central nervous system of children. Preliminary results
[Relazione in Atti di Convegno]
Vivoli, Gianfranco; Bergomi, Margherita; Borella, Paola; A., Tampieri; F., Bruno; P. L., Tartoni; N., Sturloni; G. B., Cavazzuti; R., Montorsi; R., Campagna; L., Simoni; D., Catelli; E., Caselgrandi
abstract
-
1984
- La contaminazione da metalli nei fanghi attuali dei fiumi Secchia e Panaro in provincia di Modena
[Articolo su rivista]
Borella, Paola; G. B., Parea; Predieri, Guerrino
abstract
La contaminazione da metalli nei fanghi attuali dei fiumi Secchia e Panaro in provincia di Modena
1984
- Programma di sicurezza di qualità per la determinazione del piombo nel sangue svolto nell'ambito della attuazione della Direttiva CEE sulla sorveglianza biologica della popolazione contro il rischio di saturnismo
[Articolo su rivista]
Morisi, G; Patriarca, M; Bortoli, A; Mattiello, G; Gelosa, L; Fortuna, E; Vivoli, Gianfranco; Borella, Paola; Bergomi, Margherita; Piovano, V; Rampa, P; Pallotti, G; Consolino, A; Alessio, L; Grilli, G; Baston, W; Leyendecker, W; Chiarotti, F; Taggi, F.
abstract
Programma di sicurezza di qualità per la determinazione del piombo nel sangue svolto nell'ambito della attuazione della Direttiva CEE sulla sorveglianza biologica della popolazione contro il rischio di saturnismo
1984
- Zinc, copper and calcium status of baby rats nurished by low lead-exposed mothers: neuro-behavioral correlates
[Relazione in Atti di Convegno]
Baraldi, Mario; P., Zanoli; Rossi, Tiziana; M., Santi; Borella, Paola; E., Caselgrandi; Bergomi, Margherita
abstract
.
1983
- Contaminazione da metalli pesanti dei latti per la nutrizione infantile. Nota I: piombo nel latte materno e vaccino
[Articolo su rivista]
Amore, F; Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina; Vivoli, G; Lauriola, P; Goldoni, Ca
abstract
Contaminazione da metalli pesanti dei latti per la nutrizione infantile. Nota I: piombo nel latte materno e vaccino
1983
- Decrease of brain zinc in experimental hepatic encephalography
[Articolo su rivista]
Baraldi, Mario; E., Caselgrandi; Borella, Paola; Zeneroli, Maria Luisa
abstract
Since zinc is an important factor in membrane stability, we assayed the levels of zinc in several brain areas during the development of hepatic encephalopathy due to D-galactosamine-HCl in rat. We now report that zinc is significantly reduced in all tested brain areas. This finding seems to indicate an involvement of zinc in the changes of membrane properties that lead to alteration of GABA receptors in hepatic encephalopathy.
1983
- Decrease of brain zinc in experimental hepatic encephalopathy
[Articolo su rivista]
Baraldi, M.; Caselgrandi, E.; Borella, P.; Zeneroli, M. L.
abstract
Since zinc is an important factor in membrane stability, we assayed the levels of zinc in several brain areas during the development of hepatic encephalopathy due to d-galactosamine-HC1 in rat. We now report that zinc is significantly reduced in all tested brain areas. This finding seems to indicate an involvement of zinc in the changes of membrane properties that lead to alteration of GABA receptors in hepatic encephalopathy. © 1983.
1983
- Interaction between Cadmium and some Biochemical Parameters involved with human hypertension
[Relazione in Atti di Convegno]
Vivoli, Gianfranco; Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina; E., Caselgrandi
abstract
-
1983
- Italian results in a quality control program for the determination of lead in blood. EEC directive 312/29-3-1977
[Articolo su rivista]
Morisi, G.; Patriarca, M.; Bortoli, A.; Mattiello, G.; Gelosa, L.; Fortuna, E.; Vivoli, G.; Borella, P.; Bergomi, M.; Piovano, V.
abstract
1983
- Relationship between stressful work, personality and catecholamine excretion
[Articolo su rivista]
Vivoli, Gianfranco; Bergomi, Margherita; Borella, Paola; Fantuzzi, Guglielmina
abstract
.
1982
- Behavior during the work week of biological indicators of exposure to lead
[Articolo su rivista]
Vivoli, Gianfranco; A., Berlin; Bergomi, Margherita; Borella, Paola; E., Caselgrandi; Fantuzzi, Guglielmina
abstract
The AA. have studied the weekly changes of haematic and urinary parameters of lead occupational exposure. For this aim, they have collected in 14 ceramic workers 3 blood samples for day and all urine samples for day and all urine samples from monday to friday. The PbB and FEP levels did not show significant variations during working week. The measurement of ALA in single urines shows that this parameter is characterized by remarkable fluctuations within the same day in all subjects examined. The correction of values by density gave negative results while the correction by creatinine decreases the daily fluctuations but only in some cases. The execution of test in urine of 24 hours seems to give the most reliable correlation with lead exposure levels because of its relative constancy during week.
1982
- Heavy metals and experimental atherosclerosis. Effect of lead intoxication on rabbit plasma lipoproteins.
[Articolo su rivista]
Tarugi, Patrizia Maria; CALANDRA BUONAURA, Sebastiano; Borella, Paola; Vivoli, Gianfranco
abstract
Previous studies have suggested that exposure to heavy metals may be a risk factor in coronary atherosclerotic heart disease in humans as well as in experimental animals. Little is known however on the mechanism underlying the effect of heavy metals on the development of atherosclerosis. In this study we tried to ascertain whether exposure to lead might: (a) alter plasma lipoprotein in normally fed rabbits; and (b) aggravate the hyperlipidemia usually found in cholesterol-fed animals. Rabbits were fed a normal diet or a diet containing 1% cholesterol in the presence or in the absence of 0.5% of lead subacetate for 45 days. This produced an accumulation of lead in plasma and bone. While in cholesterol-fed rabbits, lead exposure did not modify the plasma lipoprotein pattern, in normally fed animals it induced a striking elevation of cholesterol esters. This was associated with an increased concentration of VLDL (1.006 g/ml), LDL1 (1.006-1.020 g/ml), LDL2 (1.020-1.050 g/ml) and HDL1 (1.050-1.210 g/ml). These lipoproteins had an elevated content of cholesterol esters and apolipoprotein B. It is suggested that some of these lipoproteins may be important in the development of atherosclerosis in subjects chronically exposed to lead.
1981
- Distribuzione dei valori dello zinco nel sie¬ro e nei capelli in bambini normali della 3a infanzia
[Articolo su rivista]
Campagnoli, F; Marzullo, G; Canonaco, F; Borella, Paola; Fantuzzi, Guglielmina; Vivoli, G.
abstract
Distribuzione dei valori dello zinco nel sie¬ro e nei capelli in bambini normali della 3a infanzia
1981
- Gas chromatographic determination of urinary metabolites of chloroethylene derivatives
[Articolo su rivista]
Vivoli, Gianfranco; Borella, Paola; Bergomi, Margherita
abstract
.
1980
- Programma comunitario sulla sorveglianza biologica della popolazione contro il rischio del saturnismo. Risultati italiani. Fase I (1978-1979)
[Articolo su rivista]
Morisi, G; Taggi, F; Martini, F; Magliola, E; Mattiello, G; Bortoli, A; Gelosa, L; Fortuna, E; Alessio, L; Vivoli, Gianfranco; Borella, Paola; Bergomi, Margherita; Pallotti, G; Consolino, A; Porozzi, G; Piovano, V; Piombino, O.
abstract
Programma comunitario sulla sorveglianza biologica della popolazione contro il rischio del saturnismo. Risultati italiani. Fase I (1978-1979)
1979
- Indagine sul contenuto in piombo degli alimenti di origine vegetale prodotti nel comprensorio delle ceramiche
[Articolo su rivista]
Borella, Paola; E., Caselgrandi; A., Pini
abstract
Indagine sul contenuto in piombo degli alimenti di origine vegetale prodotti nel comprensorio delle ceramiche
1979
- Indagini sulla qualità delle acque del fiume Oglio dal lago d'Iseo alla foce
[Articolo su rivista]
E., Bellelli; U., Bracchi; G., Nardi; G., Sansebastiano; M. L., Tanzi; R., Olivo; Vivoli, Gianfranco; Aggazzotti, Gabriella; Bergomi, Margherita; Borella, Paola; L., Ferrari
abstract
-
1979
- Ulteriori osservazioni sulla intossicazione saturnina nei lavoratori dell'industria ceramica
[Articolo su rivista]
Vivoli, G; Olivo, R; Borella, Paola; Pini, A; Fantuzzi, Guglielmina; Caselgrandi, E.
abstract
Ulteriori osservazioni sulla intossicazione saturnina nei lavoratori dell'industria ceramica
1978
- Distribution of serum lead values in population groups with different exposure levels
[Articolo su rivista]
Borella, Paola; A., Pini; R., Olivo; Vivoli, Gianfranco
abstract
.
1978
- Indagine su eventuali rapporti tra disturbi neurologici e aumentato assorbimento di piombo in età infantile
[Articolo su rivista]
G. B., Cavazzuti; Vivoli, Gianfranco; Bergomi, Margherita; Borella, Paola; P., Ferrari; N., Sturloni
abstract
Indagine su eventuali rapporti tra disturbi neurologici e aumentato assorbimento di piombo in età infantile
1978
- Study of the reduction of serum lead and various trace elements induced by treatment with EDTA calcium disodium
[Articolo su rivista]
Vivoli, Gianfranco; Bergomi, Margherita; Borella, Paola; E., Caselgrandi; A., Pini; L., Vandelli; S., Zini; P., Borgatti
abstract
.
1976
- Alcuni problemi igienici legati all'industria delle ceramiche. Parte 2°- Riflessi dell'inquinamento atmosferico sullo stato di salute della popolazione.
[Articolo su rivista]
Aggazzotti, Gabriella; F., Amore; Bergomi, Margherita; Borella, Paola; G., Fontana; R., Olivo; Tampieri, Auro; Vecchi, Gian Paolo; Vivoli, Gianfranco
abstract
Una vasta indagine copndotta nella popolazione scolastica del comprensorio modenese delle ceramiche ha dimostrato che la contaminazione ambientale da piombo nell'area considerata determina un sensibile aumento dell'assorbimento del metallo, docunmentato da significativi incrementi dei valori della piomburia e dell'ALA urinario rispetto a gruppi omogenei di controllo. Alle suddette variazioni si associa con una certa sistematicità una maggiore frequenza di disturbi comportamentali.Relativamente alla popolazione adulta, la prevalenza di abortività nel comune di Sassuolo è probabilmente da ricondursi all'elevato numeron di donne occupate nell'industria ceramica dove al notevole impegno fisico si sovrappone, come fattore di rischio aggiuntivo, l'assorbimento di composti piombiferi.
1976
- Alcuni problemi igienici legati all'industria delle ceramiche. Parte 4a. Stato di salute degli addetti all'industria ceramica in rapporto alla contaminazione ambientale da piombo
[Articolo su rivista]
Bergomi, Margherita; Borella, Paola; G., Fontana; R., Olivo; A., Tampieri; G., Vecchi; Vivoli, Gianfranco
abstract
Stato di salute degli addetti all'industria ceramica in rapporto alla contaminazione ambientale da piombo
1974
- Comportamento dell'attività ALA deidratasica eritrocitaria in rapporto alle abitudini fumatorie
[Articolo su rivista]
Vivoli, Gianfranco; G., Vecchi; L., Rinaldi Ferrari; Borella, Paola
abstract
Comportamento dell'attività ALA deidratasica eritrocitaria in rapporto alle abitudini fumatorie