Chikungunva virus is a mosquito-transmitted alphavirus that causes chikungunva fever,a febrile illness associated with severe arthralgia and rash.Chikungunva virus is transmitted by culicine mosquitoes:Chikungunya vir...Chikungunva virus is a mosquito-transmitted alphavirus that causes chikungunva fever,a febrile illness associated with severe arthralgia and rash.Chikungunva virus is transmitted by culicine mosquitoes:Chikungunya virus replicates in the skin,disseminates to liver,muscle,joints.lymphoid tissue and brain,presumably through the blood.Phylogenetic studies showed that the Indian Ocean and the Indian subcontinent epidemics were caused by two different introductions of distinct strains of East/Central/South African genotype of CHIKV.The paraphyletic grouping of African CHIK viruses supports the historical evidence that the virus was introduced into Asia from Africa.Phylogenetic analysis divided Chikungunva virus isolates into three distinct genotypes based on geographical origins:the first,the West Africa genotype,consisted of isolates from Senegal and Nigeria;the second contained strains from East/Central/South African genotype,while the third contained solely Asian.The most recent common ancestor for the recent epidemic,which ravaged Indian Ocean islands and Indian subcontinent in 2004- 2007.was found to date in 2002.Asian lineage dated about 1952 and exhibits similar spread patterns of the recent Indian Ocean outbreak lineage,with successive epidemics detected along an eastward path.Asian group splitted into two clades:an Indian lineage and a south east lineage.Outbreaks of Chikungunya virus fever in Asia have not been associated necessarily with outbreaks in Africa.Phylogenetic tools can reconstruct geographic spread of Chikungunva virus during the epidemics wave.The good management of patients with acute Chikungunva virus infection is essential for public health in susceptible areas with current Aedes spp activity.展开更多
Nipah virus(Ni V)is a member of the genus Henipavirus of the family Paramyxoviridae,characterized by high pathogenicity and endemic in South Asia.It is classified as a Biosafety Level-4(BSL-4)agent.The case-fatality v...Nipah virus(Ni V)is a member of the genus Henipavirus of the family Paramyxoviridae,characterized by high pathogenicity and endemic in South Asia.It is classified as a Biosafety Level-4(BSL-4)agent.The case-fatality varies from 40%-70%depending on the severity of the disease and on the availability of adequate healthcare facilities.At present no antiviral drugs are available for Ni V disease and the treatment is just supportive.Phylogenetic and evolutionary analyses can be used to help in understanding the epidemiology and the temporal origin of this virus.This review provides an overview of evolutionary studies performed on Nipah viruses circulating in different countries.Thirty phylogenetic studies have been published from 2000 to 2015 years,searching on pub-med using the key words‘Nipah virus AND phylogeny'and twenty-eight molecular epidemiological studies from 2006 to 2015 have been performed,typing the key words‘Nipah virus AND molecular epidemiology'.Overall data from the published study demonstrated as phylogenetic and evolutionary analysis represent promising tools to evidence NiV epidemics,to study their origin and evolution and finally to act with effective preventive measure.展开更多
Hepatitis B virus(HBV)is the leading cause of liver disease and infects an estimated 240 million people worldwide.It is characterised by a high degree of genetic heterogeneity because of the use of a reverse transcrip...Hepatitis B virus(HBV)is the leading cause of liver disease and infects an estimated 240 million people worldwide.It is characterised by a high degree of genetic heterogeneity because of the use of a reverse transcriptase during viral replication.The ten genotypes(A-J)that have been described so far further segregate into a number of subgenotypes which have distinct ethno-geographic distribution.Genotypes A and D are ubiquitous and the most prevalent genotypes in Europe(mainly represented by subgenotypes D1-3 and A2);genotypes B and C are restricted to eastern Asia and Oceania;genotype E to central and western Africa;and genotypes H and F(classified into 4 subgenotypes)to Latin America and Alaska.This review summarises the data obtained by studying the global phylodynamics and phylogeography of HBV genotypes,particularly those concerning the origin and dispersion histories of genotypes A,D,E and F and their subgenotypes.The lack of any consensus concerning the HBV substitution rate and the conflicting data obtained using different calibration approaches make the time of origin and divergence of the various genotypes and subgenotypes largely uncertain.It is hypothesised that HBV evolutionary rates are time dependent,and that the changes depend on the main transmission routes of the genotypes and the dynamics of the infected populations.展开更多
BACKGROUND The role of preoperative inflammatory biomarkers(PIBs)in predicting postoperative morbidity has been assessed in colorectal and otorhinolaryngeal surgery.However,data regarding the role that preoperative in...BACKGROUND The role of preoperative inflammatory biomarkers(PIBs)in predicting postoperative morbidity has been assessed in colorectal and otorhinolaryngeal surgery.However,data regarding the role that preoperative inflammatory biomarkers have on morbidity after pancreaticoduodenectomiy(PD)are less consistent.AIM To assess the utility of PIBs in predicting postoperative complications after pancreaticoduodenectomy.METHODS A database of 317 consecutive pancreaticoduodenectomies performed from April 2003 to November 2018 has been retrospectively analyzed.Data regarding preoperative neutrophil-to-lymphocyte ratio(NLR),derived NLR and C-reactive protein(CRP),and postoperative complications of 238 cases have been evaluated.Exclusion criteria were:age<18-years-old,previous neoadjuvant treatment,absence of data about PIBs,concomitant hematological disorders,and presence of active infections at the moment of the surgery.PIBs were compared using Mann-Whitney’s test and receiver operating characteristic(ROC)analysis was performed to define the cutoffs.The positive predictive value(PPV)was computed to evaluate the probability to develop complication.P-values<0.05 were considered statistically significant.RESULTS According to the literature findings,only four papers have been published reporting the relation between the inflammatory biomarkers and PD postoperative morbidity.A combination of preoperative and postoperative inflammatory biomarkers in predicting complications after PD and the utility of preoperative NLR in the development of postoperative pancreatic fistula(POPF)have been reported.The combination of PIBs and postoperative day-1 drains amylase has been reported to predict the incidence of POPF.According to our results,CRP values were significantly different between patients who had/did not have postoperative complications and abdominal collections(P<0.05).Notably,patients with preoperative CRP>8.81 mg/dL were at higher risk of both overall complications and abdominal collections(respectively P=0.0037,PPV=0.95,negative predictive value[NPV]=0.27 and P=0.016,PPV=0.59,NPV=0.68).Preoperative derived neutrophil-to-lymphocyte ratio(dNLR)(cut off>1.47)was also a predictor of abdominal collection(P=0.021,PPV=0.48,NPV=0.71).Combining CRP and dNLR,PPV increased to 0.67.NLR(cut off>1.65)was significantly associated with postoperative hemorrhage(P=0.016,PPV=0.17,NPV=0.98).CONCLUSION PIBs may predict complications after PD.During postoperative care,PIB levels could influence decisions regarding the timing of drains removal and the selection of patients who might benefit from second level diagnostic exams.展开更多
BACKGROUND Insulin resistance(IR)is the main complication found in 35%-80%of women with polycystic ovary syndrome(PCOS).However,there is no definite consensus regarding which marker to use for its assessment in PCOS w...BACKGROUND Insulin resistance(IR)is the main complication found in 35%-80%of women with polycystic ovary syndrome(PCOS).However,there is no definite consensus regarding which marker to use for its assessment in PCOS women.Research has shown that hyperinsulinemia is correlated with increased bone mass.Given that most women with PCOS are insulin resistant,which is independent from body fat and characterized by hyperinsulinemia,it could be hypothesized that there would be an increased bone mass in the patient as a result.Subsequently,increased bone mass could be measured using the wrist circumference method.AIM To assess the wrist circumference as an easy-to-detect marker of IR in Congolese women with PCOS.METHODS Seventy-two Congolese women with PCOS and seventy-one controls from the same ethnic group,were enrolled in the study(mean age 24.33±5.36 years).Fasting biochemical parameters,and the Homeostasis Model Assessment of insulin resistance(HOMA-IR)and body composition were evaluated.The nondominant wrist circumference was measured manually,as was the waist circumference(WC),hip circumference,height and weight.Calculated measures included evaluation of body mass index(BMI),Waist-to-Height(WHtR)and Waist-to-hip ratio(WHR).In addition,body composition was assessed by Bioelectrical Impedance Analysis using a body fat analyzer.RESULTS The non-dominant wrist circumference was more closely correlated with HOMAIR(r=0.346;P=0.003)and was the best anthropometrical marker correlated with IR(P=0.011)compared with other anthropometrical markers in women with PCOS:Dominant Wrist Circumference(r=0.315;P=0.007),Waist Circumference(WC)(r=0.259;P=0.028),BMI(r=0.285;P=0.016),WHR(r=0.216;P=0,068)and WHtR(r=0.263;P=0.027).The diagnostic accuracy of the non-dominant wrist circumference for the presence or absence of IR using Receiver-operating characteristic(ROC)curve analysis showed that the area under the ROC curve was 0.72.A cutoff value for the non-dominant wrist circumference of 16.3 cm was found to be the best predictor of IR in Congolese women with PCOS.CONCLUSION Non-dominant wrist circumference is,to date,the best anthropometrical marker of IR in Sub-Saharan African women with PCOS.It could be suggested as an easy-to-detect marker for assessing IR.展开更多
A relevant gradual reduction of both the incidence rate of acute hepatitis B(AHB)and prevalence of chronic hepatitis B has occurred in Italy in the last 50 years,due to substantial epidemiological changes:Improvement ...A relevant gradual reduction of both the incidence rate of acute hepatitis B(AHB)and prevalence of chronic hepatitis B has occurred in Italy in the last 50 years,due to substantial epidemiological changes:Improvement in socioeconomic and hygienic conditions,reduction of the family unit,accurate screening of blood donations,abolition of re-usable glass syringes,hepatitis B virus(HBV)-universal vaccination started in 1991,use of effective well tolerated nucleo(t)side analogues able to suppress HBV replication available from 1998,and educational mediatic campaigns against human immunodeficiency virus infection focusing on the prevention of sexual and parenteral transmission of infections.As an example,AHB incidence has gradually decreased from 10/100000 inhabitants in 1985 to 0.21 in 2020.Unfortunately,the coronavirus disease 2019(COVID-19)pandemic has interrupted the trend towards HBV eradication.In fact,several HBV chronic carriers living in the countryside have become unable to access healthcare facilities for screening,diagnosis,clinical management,and nucleo(t)side analogue therapy in the COVID-19 pandemic,mainly for anxiety of becoming infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),movement restrictions,and reduced gains from job loss.In addition,one-third of healthcare facilities and personnel for HBV patients have been devolved to the COVID-19 assistance.展开更多
Objective: To investigate the genetic diversity of Zika virus(ZIKV) and the relationships existing among these circulating viruses worldwide. To evaluate the genetic polymorphisms harboured from ZIKV that can have an ...Objective: To investigate the genetic diversity of Zika virus(ZIKV) and the relationships existing among these circulating viruses worldwide. To evaluate the genetic polymorphisms harboured from ZIKV that can have an influence on the virus circulation. Methods: Three different ZIKV dataset were built. The first dataset included 63 E gene sequences, the second one 22 NS3 sequences and the third dataset was composed of 108 NS5 gene sequences. Phylogenetic and selective pressure analysis was performed. The edited nucleic acid alignment from the Envelope dataset was used to generate a conceptual translation to the corresponding peptide sequences through UGene software. Results: The phylogeographic reconstruction was able to discriminate unambiguously that the Brazilian strains are belonged to the Asian lineage. The structural analysis reveals instead the presence of the Ser residue in the Brazilian sequences(however already observed in other previously reported ZIKV infections) that could suggest the presence of a neutralization-resistant population of viruses. Conclusions: Phylogenetic, evolutionary and selective pressure analysis contributed to improve the knowledge on the circulation of ZIKV.展开更多
Objective:To study the genetic diversity of Murray Valley encephalitis virus(MVEV)in Australia and Papua New Guinea.Methods:MVEV envelope gene sequences were aligned using Clustal X and manual editing was performed wi...Objective:To study the genetic diversity of Murray Valley encephalitis virus(MVEV)in Australia and Papua New Guinea.Methods:MVEV envelope gene sequences were aligned using Clustal X and manual editing was performed with Bioedit.ModelTest v.3.7 was used to select the simplest evolutionary model that adequately fitted the sequence data.Maximum likelihood analysis was performed using PhyML.The phylogenetic signal of the dataset wa.s investigated by the likelihood mapping analysis.The Bayesian phylogenetic tree was built using BEAST.Results:The phylogenetic trees showed two main clades.The cladeⅠincluding eight strains isolated from West Australia.The cladeⅡwas characterized by at least four epidemic entries,three of which localized in Northern West Australia and one in Papua New Guinea.The estimated mean evolutionary rate value of the MVEV envelope gene wa.s0.407×10^(-3)substitution/site/year(95%HPD:0.623×10^(4)-0.780×10^(-3)).Population dynamics defines a relative constant population until the year 2000.when a reduction occurred,probably due to a bottleneck.Conclusions:This study has been useful in supporting the probable connection between climate changes and viral evolution also by the vector point of view:multidisciplinary monitoring studies are important to prevent new viral epidemics inside and outside new endemic areas.展开更多
Objective: To study the genetic diversity of Culex theileri flavivirus and the spread of this virus among Spain, Portugal and Turkey.Methods: A database consisting of 55 sequences of the NS5/3'UTR region of Culex ...Objective: To study the genetic diversity of Culex theileri flavivirus and the spread of this virus among Spain, Portugal and Turkey.Methods: A database consisting of 55 sequences of the NS5/3'UTR region of Culex theileri flavivirus group downloaded from GenBank were aligned and manual edited with Bioedit.ModelT est v.3.7 was used to select the simplest evolutionary model that adequately fitted the sequence data.Maximum likelihood analysis was performed using MEGA7.The phylogenetic signal of the dataset was investigated by the likelihood mapping analysis.Results: The phylogenetic tree showed three clusters.Myanmar sequences clusterd together with Turkish sequences, Spain and Portugal strains grouped together and two Turkish sequences grouped separately.Selective pressure analysis showed a moderate percentage of sites(22.5%) under pervasive negative selection and only 1% under pervasive positive selection.The sites subject to selective pressure in CTFV RdRp NS5 fragments have been located onto the predicted three-dimensional structure.Conclusions: Phylogenetic and evolutionary analysis can be an important tool for understanding the evolutionary impact of the probable contemporary existence between nonpathogenic and pathogenic flaviviruses among these vectors.展开更多
Objective: To estimate the genetic diversity of Kokobera virus, the date of origin and the spread among different viruses in the endemic regions of Australia. Methods: Two datasets were built. The first consisting of ...Objective: To estimate the genetic diversity of Kokobera virus, the date of origin and the spread among different viruses in the endemic regions of Australia. Methods: Two datasets were built. The first consisting of 29 sequences of the NS5/3' UTR region of Kokobera group downloaded from Gen Bank, the second including only 24 sequences of Kokobera viruses, focus is on this group. Results: Bayesian time analysis revealed two different entries in Australia of Kokobera virus in the 50 s years with the dated ancestor in 1861 year. Clade A and B showed a clear separation of the Kokobera sequences according to the geographic region. Conclusions: Data from the study showed as Kokobera virus, despite of its ancient origin and its circulation before the European colonization, remained limited to the Australian Country and nowadays limited mostly to the regions were Australian marsupials are mostly found.展开更多
Objective:To explore the genetic diversity and the modification of antibody response in the recent outbreak of Ebola Virus.Methods:Sequences retrieved from public databases,the selective pressure analysis and the homo...Objective:To explore the genetic diversity and the modification of antibody response in the recent outbreak of Ebola Virus.Methods:Sequences retrieved from public databases,the selective pressure analysis and the homology modelling based on the all protein(nucleoprotein.VP35,VP40.soluble glycoprotein,small soluble glycoprotein.VP30,VP24 and polymerase)were used.Results:Structural proteins VP24.VP30.VP35 and VP40 showed relative conserved sequences making them suitable target candidates for antiviral treatment.On the contrary,nucleoprotein.polymerase and soluble glycoprotein have high mutation frequency.Conclusions:Data from this study point out important aspects of Ebola virus sequence variability that for epitope and vaccine design should be considered for appropriate targeting of conserved protein regions.展开更多
To the Editor,We read with great interest the recent review by Limongi et al.on sepsis biomarkers[1].Recently,the combined use of two biomarkers,procalcitonin(PCT)and mid-regional proadrenomedullin(MR-pro ADM)has been...To the Editor,We read with great interest the recent review by Limongi et al.on sepsis biomarkers[1].Recently,the combined use of two biomarkers,procalcitonin(PCT)and mid-regional proadrenomedullin(MR-pro ADM)has been reported in sepsis diagnosis and prognosis.PCT is a polypeptide produced as a precursor of calcitonin by thyroid C cells normally展开更多
Objective:To evaluate the evolution of the pathogen Mayaro virus,causing Mayaro fever(a mosquito-borne disease)and to perform selective pressure analysis and homology modelling.Methods:Nine different datasets were bui...Objective:To evaluate the evolution of the pathogen Mayaro virus,causing Mayaro fever(a mosquito-borne disease)and to perform selective pressure analysis and homology modelling.Methods:Nine different datasets were built,one for each protein(from protein C to non-structural protein 4)and the last one for the complete genome.Selective pressure and homology modelling analyses were applied.Results:Two main clades(A and B)were pointed in the maximum likelihood tree.The clade A included five Brazilian sequences sampled from 1955 to 2015.The Brazilian sequence sampled in 2014 significantly clustered with the Haitian sequence sampled in 2015.The clade B included the remaining 27 sequences sampled in the Central and Southern America from 1957 to 2013.Selective pressure analysis revealed several sites under episodic diversifying selection in envelope surface glycoprotein El,non-structural protein 1 and nonstructural protein 3 with a posterior probability P≤0.01.Homology modelling showed different sites modified by selective pressure and some protein-protein interaction sites at high interaction propensity.Conclusion:Maximum likelihood analysis confirmed the Mayaro virus previous circulation in Haiti and the successful spread to the Caribbean and USA.Selective pressure analysis revealed a strong presence of negatively selected sites,suggesting a probable purging of deleterious polymorphisms in functional genes.Homology model showed the position 31,under selective pressure,located in the edge of the ADP-ribose binding site predicting to possess a high potential of protein-protein interaction and suggesting the possible chance for a protective vaccine,thus preventing Mayaro virus urbanization as with Chikungunya virus.展开更多
BACKGROUND Postoperative pancreatic fistula(POPF)is the most fearful complication after pancreatic surgery and can lead to severe postoperative complications such as surgical site infections,sepsis and bleeding.A prev...BACKGROUND Postoperative pancreatic fistula(POPF)is the most fearful complication after pancreatic surgery and can lead to severe postoperative complications such as surgical site infections,sepsis and bleeding.A previous study which identified cut-offs of drains amylase levels(DALs)determined on postoperative day(POD)1 and POD3,was able to significantly predict POPF,abdominal collections and biliary fistulas,when related to specific findings detected at the abdominal computerized tomography(CT)scan routinely performed on POD3.AIM To validate the cut-offs of DALs in POD1 and POD3,established during the previous study,to assess the risk of clinically relevant POPF and confirm the usefulness of abdominal CT scan on POD3 in patients at increased risk of abdominal collection.METHODS The DALCUT trial is an interventional prospective study.All patients who will undergo pancreatoduodenectomy(PD)for periampullary neoplasms will be considered eligible.All patients will receive clinical staging and,if eligible for surgery,will undergo routine preoperative evaluation.After the PD,daily DALs will be evaluated from POD1.Drains removal and possible requirement of abdominal CT scans in POD3 will be managed on the basis of the outcome of DALs in the first three postoperative days.RESULTS This prospective study could validate the role of DALs in the management of surgical drains and in assessing the risk or relevant complications after PD.Drains could be removed in POD3 in case of POD1 DALs<666 U/L and POD3 DALs<207 U/L.In case of POD3 DALs≥252,abdominal CT scan will be performed in POD3 to identify abdominal collections≥5 cm.In this latter category of patients,drains could be maintained beyond POD3.CONCLUSION The results of this trial will contribute to a better knowledge of POPF and management of surgical drains.展开更多
文摘Chikungunva virus is a mosquito-transmitted alphavirus that causes chikungunva fever,a febrile illness associated with severe arthralgia and rash.Chikungunva virus is transmitted by culicine mosquitoes:Chikungunya virus replicates in the skin,disseminates to liver,muscle,joints.lymphoid tissue and brain,presumably through the blood.Phylogenetic studies showed that the Indian Ocean and the Indian subcontinent epidemics were caused by two different introductions of distinct strains of East/Central/South African genotype of CHIKV.The paraphyletic grouping of African CHIK viruses supports the historical evidence that the virus was introduced into Asia from Africa.Phylogenetic analysis divided Chikungunva virus isolates into three distinct genotypes based on geographical origins:the first,the West Africa genotype,consisted of isolates from Senegal and Nigeria;the second contained strains from East/Central/South African genotype,while the third contained solely Asian.The most recent common ancestor for the recent epidemic,which ravaged Indian Ocean islands and Indian subcontinent in 2004- 2007.was found to date in 2002.Asian lineage dated about 1952 and exhibits similar spread patterns of the recent Indian Ocean outbreak lineage,with successive epidemics detected along an eastward path.Asian group splitted into two clades:an Indian lineage and a south east lineage.Outbreaks of Chikungunya virus fever in Asia have not been associated necessarily with outbreaks in Africa.Phylogenetic tools can reconstruct geographic spread of Chikungunva virus during the epidemics wave.The good management of patients with acute Chikungunva virus infection is essential for public health in susceptible areas with current Aedes spp activity.
文摘Nipah virus(Ni V)is a member of the genus Henipavirus of the family Paramyxoviridae,characterized by high pathogenicity and endemic in South Asia.It is classified as a Biosafety Level-4(BSL-4)agent.The case-fatality varies from 40%-70%depending on the severity of the disease and on the availability of adequate healthcare facilities.At present no antiviral drugs are available for Ni V disease and the treatment is just supportive.Phylogenetic and evolutionary analyses can be used to help in understanding the epidemiology and the temporal origin of this virus.This review provides an overview of evolutionary studies performed on Nipah viruses circulating in different countries.Thirty phylogenetic studies have been published from 2000 to 2015 years,searching on pub-med using the key words‘Nipah virus AND phylogeny'and twenty-eight molecular epidemiological studies from 2006 to 2015 have been performed,typing the key words‘Nipah virus AND molecular epidemiology'.Overall data from the published study demonstrated as phylogenetic and evolutionary analysis represent promising tools to evidence NiV epidemics,to study their origin and evolution and finally to act with effective preventive measure.
文摘Hepatitis B virus(HBV)is the leading cause of liver disease and infects an estimated 240 million people worldwide.It is characterised by a high degree of genetic heterogeneity because of the use of a reverse transcriptase during viral replication.The ten genotypes(A-J)that have been described so far further segregate into a number of subgenotypes which have distinct ethno-geographic distribution.Genotypes A and D are ubiquitous and the most prevalent genotypes in Europe(mainly represented by subgenotypes D1-3 and A2);genotypes B and C are restricted to eastern Asia and Oceania;genotype E to central and western Africa;and genotypes H and F(classified into 4 subgenotypes)to Latin America and Alaska.This review summarises the data obtained by studying the global phylodynamics and phylogeography of HBV genotypes,particularly those concerning the origin and dispersion histories of genotypes A,D,E and F and their subgenotypes.The lack of any consensus concerning the HBV substitution rate and the conflicting data obtained using different calibration approaches make the time of origin and divergence of the various genotypes and subgenotypes largely uncertain.It is hypothesised that HBV evolutionary rates are time dependent,and that the changes depend on the main transmission routes of the genotypes and the dynamics of the infected populations.
文摘BACKGROUND The role of preoperative inflammatory biomarkers(PIBs)in predicting postoperative morbidity has been assessed in colorectal and otorhinolaryngeal surgery.However,data regarding the role that preoperative inflammatory biomarkers have on morbidity after pancreaticoduodenectomiy(PD)are less consistent.AIM To assess the utility of PIBs in predicting postoperative complications after pancreaticoduodenectomy.METHODS A database of 317 consecutive pancreaticoduodenectomies performed from April 2003 to November 2018 has been retrospectively analyzed.Data regarding preoperative neutrophil-to-lymphocyte ratio(NLR),derived NLR and C-reactive protein(CRP),and postoperative complications of 238 cases have been evaluated.Exclusion criteria were:age<18-years-old,previous neoadjuvant treatment,absence of data about PIBs,concomitant hematological disorders,and presence of active infections at the moment of the surgery.PIBs were compared using Mann-Whitney’s test and receiver operating characteristic(ROC)analysis was performed to define the cutoffs.The positive predictive value(PPV)was computed to evaluate the probability to develop complication.P-values<0.05 were considered statistically significant.RESULTS According to the literature findings,only four papers have been published reporting the relation between the inflammatory biomarkers and PD postoperative morbidity.A combination of preoperative and postoperative inflammatory biomarkers in predicting complications after PD and the utility of preoperative NLR in the development of postoperative pancreatic fistula(POPF)have been reported.The combination of PIBs and postoperative day-1 drains amylase has been reported to predict the incidence of POPF.According to our results,CRP values were significantly different between patients who had/did not have postoperative complications and abdominal collections(P<0.05).Notably,patients with preoperative CRP>8.81 mg/dL were at higher risk of both overall complications and abdominal collections(respectively P=0.0037,PPV=0.95,negative predictive value[NPV]=0.27 and P=0.016,PPV=0.59,NPV=0.68).Preoperative derived neutrophil-to-lymphocyte ratio(dNLR)(cut off>1.47)was also a predictor of abdominal collection(P=0.021,PPV=0.48,NPV=0.71).Combining CRP and dNLR,PPV increased to 0.67.NLR(cut off>1.65)was significantly associated with postoperative hemorrhage(P=0.016,PPV=0.17,NPV=0.98).CONCLUSION PIBs may predict complications after PD.During postoperative care,PIB levels could influence decisions regarding the timing of drains removal and the selection of patients who might benefit from second level diagnostic exams.
文摘BACKGROUND Insulin resistance(IR)is the main complication found in 35%-80%of women with polycystic ovary syndrome(PCOS).However,there is no definite consensus regarding which marker to use for its assessment in PCOS women.Research has shown that hyperinsulinemia is correlated with increased bone mass.Given that most women with PCOS are insulin resistant,which is independent from body fat and characterized by hyperinsulinemia,it could be hypothesized that there would be an increased bone mass in the patient as a result.Subsequently,increased bone mass could be measured using the wrist circumference method.AIM To assess the wrist circumference as an easy-to-detect marker of IR in Congolese women with PCOS.METHODS Seventy-two Congolese women with PCOS and seventy-one controls from the same ethnic group,were enrolled in the study(mean age 24.33±5.36 years).Fasting biochemical parameters,and the Homeostasis Model Assessment of insulin resistance(HOMA-IR)and body composition were evaluated.The nondominant wrist circumference was measured manually,as was the waist circumference(WC),hip circumference,height and weight.Calculated measures included evaluation of body mass index(BMI),Waist-to-Height(WHtR)and Waist-to-hip ratio(WHR).In addition,body composition was assessed by Bioelectrical Impedance Analysis using a body fat analyzer.RESULTS The non-dominant wrist circumference was more closely correlated with HOMAIR(r=0.346;P=0.003)and was the best anthropometrical marker correlated with IR(P=0.011)compared with other anthropometrical markers in women with PCOS:Dominant Wrist Circumference(r=0.315;P=0.007),Waist Circumference(WC)(r=0.259;P=0.028),BMI(r=0.285;P=0.016),WHR(r=0.216;P=0,068)and WHtR(r=0.263;P=0.027).The diagnostic accuracy of the non-dominant wrist circumference for the presence or absence of IR using Receiver-operating characteristic(ROC)curve analysis showed that the area under the ROC curve was 0.72.A cutoff value for the non-dominant wrist circumference of 16.3 cm was found to be the best predictor of IR in Congolese women with PCOS.CONCLUSION Non-dominant wrist circumference is,to date,the best anthropometrical marker of IR in Sub-Saharan African women with PCOS.It could be suggested as an easy-to-detect marker for assessing IR.
文摘A relevant gradual reduction of both the incidence rate of acute hepatitis B(AHB)and prevalence of chronic hepatitis B has occurred in Italy in the last 50 years,due to substantial epidemiological changes:Improvement in socioeconomic and hygienic conditions,reduction of the family unit,accurate screening of blood donations,abolition of re-usable glass syringes,hepatitis B virus(HBV)-universal vaccination started in 1991,use of effective well tolerated nucleo(t)side analogues able to suppress HBV replication available from 1998,and educational mediatic campaigns against human immunodeficiency virus infection focusing on the prevention of sexual and parenteral transmission of infections.As an example,AHB incidence has gradually decreased from 10/100000 inhabitants in 1985 to 0.21 in 2020.Unfortunately,the coronavirus disease 2019(COVID-19)pandemic has interrupted the trend towards HBV eradication.In fact,several HBV chronic carriers living in the countryside have become unable to access healthcare facilities for screening,diagnosis,clinical management,and nucleo(t)side analogue therapy in the COVID-19 pandemic,mainly for anxiety of becoming infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),movement restrictions,and reduced gains from job loss.In addition,one-third of healthcare facilities and personnel for HBV patients have been devolved to the COVID-19 assistance.
文摘Objective: To investigate the genetic diversity of Zika virus(ZIKV) and the relationships existing among these circulating viruses worldwide. To evaluate the genetic polymorphisms harboured from ZIKV that can have an influence on the virus circulation. Methods: Three different ZIKV dataset were built. The first dataset included 63 E gene sequences, the second one 22 NS3 sequences and the third dataset was composed of 108 NS5 gene sequences. Phylogenetic and selective pressure analysis was performed. The edited nucleic acid alignment from the Envelope dataset was used to generate a conceptual translation to the corresponding peptide sequences through UGene software. Results: The phylogeographic reconstruction was able to discriminate unambiguously that the Brazilian strains are belonged to the Asian lineage. The structural analysis reveals instead the presence of the Ser residue in the Brazilian sequences(however already observed in other previously reported ZIKV infections) that could suggest the presence of a neutralization-resistant population of viruses. Conclusions: Phylogenetic, evolutionary and selective pressure analysis contributed to improve the knowledge on the circulation of ZIKV.
文摘Objective:To study the genetic diversity of Murray Valley encephalitis virus(MVEV)in Australia and Papua New Guinea.Methods:MVEV envelope gene sequences were aligned using Clustal X and manual editing was performed with Bioedit.ModelTest v.3.7 was used to select the simplest evolutionary model that adequately fitted the sequence data.Maximum likelihood analysis was performed using PhyML.The phylogenetic signal of the dataset wa.s investigated by the likelihood mapping analysis.The Bayesian phylogenetic tree was built using BEAST.Results:The phylogenetic trees showed two main clades.The cladeⅠincluding eight strains isolated from West Australia.The cladeⅡwas characterized by at least four epidemic entries,three of which localized in Northern West Australia and one in Papua New Guinea.The estimated mean evolutionary rate value of the MVEV envelope gene wa.s0.407×10^(-3)substitution/site/year(95%HPD:0.623×10^(4)-0.780×10^(-3)).Population dynamics defines a relative constant population until the year 2000.when a reduction occurred,probably due to a bottleneck.Conclusions:This study has been useful in supporting the probable connection between climate changes and viral evolution also by the vector point of view:multidisciplinary monitoring studies are important to prevent new viral epidemics inside and outside new endemic areas.
文摘Objective: To study the genetic diversity of Culex theileri flavivirus and the spread of this virus among Spain, Portugal and Turkey.Methods: A database consisting of 55 sequences of the NS5/3'UTR region of Culex theileri flavivirus group downloaded from GenBank were aligned and manual edited with Bioedit.ModelT est v.3.7 was used to select the simplest evolutionary model that adequately fitted the sequence data.Maximum likelihood analysis was performed using MEGA7.The phylogenetic signal of the dataset was investigated by the likelihood mapping analysis.Results: The phylogenetic tree showed three clusters.Myanmar sequences clusterd together with Turkish sequences, Spain and Portugal strains grouped together and two Turkish sequences grouped separately.Selective pressure analysis showed a moderate percentage of sites(22.5%) under pervasive negative selection and only 1% under pervasive positive selection.The sites subject to selective pressure in CTFV RdRp NS5 fragments have been located onto the predicted three-dimensional structure.Conclusions: Phylogenetic and evolutionary analysis can be an important tool for understanding the evolutionary impact of the probable contemporary existence between nonpathogenic and pathogenic flaviviruses among these vectors.
文摘Objective: To estimate the genetic diversity of Kokobera virus, the date of origin and the spread among different viruses in the endemic regions of Australia. Methods: Two datasets were built. The first consisting of 29 sequences of the NS5/3' UTR region of Kokobera group downloaded from Gen Bank, the second including only 24 sequences of Kokobera viruses, focus is on this group. Results: Bayesian time analysis revealed two different entries in Australia of Kokobera virus in the 50 s years with the dated ancestor in 1861 year. Clade A and B showed a clear separation of the Kokobera sequences according to the geographic region. Conclusions: Data from the study showed as Kokobera virus, despite of its ancient origin and its circulation before the European colonization, remained limited to the Australian Country and nowadays limited mostly to the regions were Australian marsupials are mostly found.
基金supported by National Institute of Health andProxagent Ltd in collaboration with University of Rome"Tor Vergata
文摘Objective:To explore the genetic diversity and the modification of antibody response in the recent outbreak of Ebola Virus.Methods:Sequences retrieved from public databases,the selective pressure analysis and the homology modelling based on the all protein(nucleoprotein.VP35,VP40.soluble glycoprotein,small soluble glycoprotein.VP30,VP24 and polymerase)were used.Results:Structural proteins VP24.VP30.VP35 and VP40 showed relative conserved sequences making them suitable target candidates for antiviral treatment.On the contrary,nucleoprotein.polymerase and soluble glycoprotein have high mutation frequency.Conclusions:Data from this study point out important aspects of Ebola virus sequence variability that for epitope and vaccine design should be considered for appropriate targeting of conserved protein regions.
文摘To the Editor,We read with great interest the recent review by Limongi et al.on sepsis biomarkers[1].Recently,the combined use of two biomarkers,procalcitonin(PCT)and mid-regional proadrenomedullin(MR-pro ADM)has been reported in sepsis diagnosis and prognosis.PCT is a polypeptide produced as a precursor of calcitonin by thyroid C cells normally
文摘Objective:To evaluate the evolution of the pathogen Mayaro virus,causing Mayaro fever(a mosquito-borne disease)and to perform selective pressure analysis and homology modelling.Methods:Nine different datasets were built,one for each protein(from protein C to non-structural protein 4)and the last one for the complete genome.Selective pressure and homology modelling analyses were applied.Results:Two main clades(A and B)were pointed in the maximum likelihood tree.The clade A included five Brazilian sequences sampled from 1955 to 2015.The Brazilian sequence sampled in 2014 significantly clustered with the Haitian sequence sampled in 2015.The clade B included the remaining 27 sequences sampled in the Central and Southern America from 1957 to 2013.Selective pressure analysis revealed several sites under episodic diversifying selection in envelope surface glycoprotein El,non-structural protein 1 and nonstructural protein 3 with a posterior probability P≤0.01.Homology modelling showed different sites modified by selective pressure and some protein-protein interaction sites at high interaction propensity.Conclusion:Maximum likelihood analysis confirmed the Mayaro virus previous circulation in Haiti and the successful spread to the Caribbean and USA.Selective pressure analysis revealed a strong presence of negatively selected sites,suggesting a probable purging of deleterious polymorphisms in functional genes.Homology model showed the position 31,under selective pressure,located in the edge of the ADP-ribose binding site predicting to possess a high potential of protein-protein interaction and suggesting the possible chance for a protective vaccine,thus preventing Mayaro virus urbanization as with Chikungunya virus.
文摘BACKGROUND Postoperative pancreatic fistula(POPF)is the most fearful complication after pancreatic surgery and can lead to severe postoperative complications such as surgical site infections,sepsis and bleeding.A previous study which identified cut-offs of drains amylase levels(DALs)determined on postoperative day(POD)1 and POD3,was able to significantly predict POPF,abdominal collections and biliary fistulas,when related to specific findings detected at the abdominal computerized tomography(CT)scan routinely performed on POD3.AIM To validate the cut-offs of DALs in POD1 and POD3,established during the previous study,to assess the risk of clinically relevant POPF and confirm the usefulness of abdominal CT scan on POD3 in patients at increased risk of abdominal collection.METHODS The DALCUT trial is an interventional prospective study.All patients who will undergo pancreatoduodenectomy(PD)for periampullary neoplasms will be considered eligible.All patients will receive clinical staging and,if eligible for surgery,will undergo routine preoperative evaluation.After the PD,daily DALs will be evaluated from POD1.Drains removal and possible requirement of abdominal CT scans in POD3 will be managed on the basis of the outcome of DALs in the first three postoperative days.RESULTS This prospective study could validate the role of DALs in the management of surgical drains and in assessing the risk or relevant complications after PD.Drains could be removed in POD3 in case of POD1 DALs<666 U/L and POD3 DALs<207 U/L.In case of POD3 DALs≥252,abdominal CT scan will be performed in POD3 to identify abdominal collections≥5 cm.In this latter category of patients,drains could be maintained beyond POD3.CONCLUSION The results of this trial will contribute to a better knowledge of POPF and management of surgical drains.
