Sapienza University of Rome

About: Sapienza University of Rome is a education organization based out in Rome, Lazio, Italy. It is known for research contribution in the topics: Population & Medicine. The organization has 62002 authors who have published 155468 publications receiving 4397244 citations. The organization is also known as: La Sapienza & Università La Sapienza di Roma.

Global hotspots and correlates of emerging zoonotic diseases

Abstract: Zoonoses originating from wildlife represent a significant threat to global health, security and economic growth, and combatting their emergence is a public health priority. However, our understanding of the mechanisms underlying their emergence remains rudimentary. Here we update a global database of emerging infectious disease (EID) events, create a novel measure of reporting effort, and fit boosted regression tree models to analyze the demographic, environmental and biological correlates of their occurrence. After accounting for reporting effort, we show that zoonotic EID risk is elevated in forested tropical regions experiencing land-use changes and where wildlife biodiversity (mammal species richness) is high. We present a new global hotspot map of spatial variation in our zoonotic EID risk index, and partial dependence plots illustrating relationships between events and predictors. Our results may help to improve surveillance and long-term EID monitoring programs, and design field experiments to test underlying mechanisms of zoonotic disease emergence.

CT colonography reporting and data system: a consensus proposal.

Abstract: Computed tomographic (CT) colonography continues to evolve rapidly. Advances in scanning and display technologies, encouraging performance data, and increased utilization necessitate clarification and standardization of results reporting in CT colonography. There are several reasons for this. First and most important, standardized reporting can better assist patients and referring physicians in making management decisions on the basis of the results of CT colonography. The precedent of the mammography Breast Imaging Reporting and Data System, or BI-RADS, schema is a strong incentive to provide a similar structure for CT colonography. Second, as more examinations are performed, the likelihood increases that radiologists interpreting results of a CT colonography examination performed at one center will require comparison to examination results and reports generated at other sites. As has been seen with mammography, a common set of terms facilitates this kind of assessment (1). Third, as utilization of CT colonography increases, our colleagues in other medical specialties, the various third-party payers, and the general public will insist on larger-scale evaluations of examination performance, examination quality, patient outcome, and cost. Here again, a common approach to interpretation will assist us in meeting these demands. Finally, a common scheme for reporting facilitates structured reporting. The purpose of this communication is to facilitate clear and consistent communication of CT colonography results. The authors—an ad hoc group of investigators active in the area of CT colonography—have collaborated to develop a reporting scheme that is coupled to recommendations for follow-up. Our group, the Working Group on Virtual Colonoscopy, includes members of the American College of Radiology Colon Cancer Committee. On the basis of our collective experience and a review of the relevant literature, we present a practical guide to the interpretation of CT colonography results: the CT Colonography Reporting and Data System, or “C-RADS.” Future multidisciplinary collaboration and longitudinal data may lead to a refinement of the terms and concepts we present here; our effort is a starting point in which we attempt to address the needs of current practice. Adequate training and rigorous quality control of examination performance are essential elements for maximizing the potential of CT colonography; however, these related topics will not be discussed here. Instead, we will focus on the interpretation and follow-up of CT colonography results in three parts: first, a description of terms useful for reporting the size, morphologic features, and location of polyps and masses; second, a description of a classification scheme for colonic lesions and suggestions for follow-up; Published online 10.1148/radiol.2361041926 Radiology 2005; 236:3–9 1 From the Division of Abdominal Imaging and Intervention, Department of Radiology/ White 270, Massachusetts General Hospital, Boston, MA 02114 (M.E.Z.). The complete list of author affiliations is at the end of this article. Received November 12, 2004; accepted November 15. Address correspondence to M.E.Z. (e-mail: mzalis@partners.org).

Sensorimotor integration in movement disorders

Abstract: Although current knowledge attributes movement disorders to a dysfunction of the basal ganglia-motor cortex circuits, abnormalities in the peripheral afferent inputs or in their central processing may interfere with motor program execution. We review the abnormalities of sensorimotor integration described in the various types of movement disorders. Several observations, including those of parkinsonian patients' excessive reliance on ongoing visual information during movement tasks, suggest that proprioception is defective in Parkinson's disease (PD). The disturbance of proprioceptive regulation, possibly related to the occurrence of abnormal muscle-stretch reflexes, might be important for generating hypometric or bradykinetic movements. Studies with somatosensory evoked potentials (SEPs), prepulse inhibition, and event-related potentials support the hypothesis of central abnormalities of sensorimotor integration in PD. In Huntington's disease (HD), changes in SEPs and long-latency stretch reflexes suggest that a defective gating of peripheral afferent input to the brain might impair sensorimotor integration in cortical motor areas, thus interfering with the processing of motor programs. Defective motor programming might contribute to some features of motor impairment in HD. Sensory symptoms are frequent in focal dystonia and sensory manipulation can modify the dystonic movements. In addition, specific sensory functions (kinaesthesia, spatial-temporal discrimination) can be impaired in patients with focal hand dystonia, thus leading to a "sensory overflow." Sensory input may be abnormal and trigger focal dystonia, or defective "gating" may cause an input-output mismatch in specific motor programs. Altogether, several observations strongly support the idea that sensorimotor integration is impaired in focal dystonia. Although elemental sensation is normal in patients with tics, tics can be associated with sensory phenomena. Some neurophysiological studies suggest that an altered "gating" mechanism also underlies the development of tics. This review underlines the importance of abnormal sensorimotor integration in the pathophysiology of movement disorders. Although the physiological mechanism remains unclear, the defect is of special clinical relevance in determining the development of focal dystonia.

EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases

Abstract: Objectives To develop evidence-based European League Against Rheumatism (EULAR) recommendations for vaccination in patients with autoimmune infl ammatory rheumatic diseases (AIIRD). Methods A EULAR task force was composed of experts representing 11 European countries, consisting of eight rheumatologists, four clinical immunologists, one rheumatologist/clinical immunologist, one infectious disease physician, one nephrologist, one paediatrician/ rheumatologist and one clinical epidemiologist. Key questions were formulated and the eligible spectrum of AIIRD, immunosuppressive drugs and vaccines were defi ned in order to perform a systematic literature review. A search was made of Medline from 1966 to October 2009 as well as abstracts from the EULAR meetings of 2008 and 2009 and the American College of Rheumatology (ACR) meetings of 2007 and 2008. Evidence was graded in categories I–IV, the strength of recommendations was graded in categories A–D and Delphi voting was applied to determine the level of agreement between the experts of the task force. Results Eight key questions and 13 recommendations addressing vaccination in patients with AIIRD were formulated. The strength of each recommendation was determined. Delphi voting revealed a very high level of agreement with the recommendations among the experts of the task force. Finally, a research agenda was proposed. Conclusion Recommendations for vaccination in patients with AIIRD based on the currently available evidence and expert opinion were formulated. More research is needed, particularly regarding the incidence of vaccine-preventable infectious diseases and the safety of vaccination in patients with AIIRD.