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1. The 'Pieve di Santa Maria' in Arezzo (Italy). From the Laser Scanner Survey to the Knowledge of the Architectural Structure

Author

Matracchi, P., Biagini, C., Sadocchi, A., and Valieri, M.

Abstract

The parish church of “Santa Maria” is considered one of the most important medieval buildings of Arezzo Although the church is attested from 11th century, it is between the 13th and 14th centuries that reached its current consistency, characterized by the particular façade with small columns on several levels and an imposing bell tower. Later, from the 16th to the 18th century, the church underwent profound transformations, that were almost completely erased by extensive restoration works in the second half of the 19th century. The architectural survey of the parish church of “Santa Maria” was carried out with a phase-shift laser scanner and a digital reflex camera (Z+F 5006h). 189 scans were performed for generating the 3D model of the church: 180 of them with high density and normal quality, lasting 5-6 minutes; the remaining ones with super high density and high quality, lasting 13-14 minutes. Vectorial drawings of plans and sections were then created from the 3D model. Thanks to laser scanner survay of the chuch, it was possible to highlight the singularity of the structure of the basilical body and the transept. The tilt of walls and columns, the variations in the thickness of the walls, the considerable deformations of some arches, the cracks and textures of the wall facing were thus shown. The information obtained attested an architectural structure created by complex construction events that over time have affected this building. The cnstructive singularities involve the medieval genesis of the building, the transformations during the following centuries and the following restoration works. These composite features are specific and common to every ancient building. This peculiar epistemological condition eschews from simplifications and requires deep and complex studies closely linked to the problems of conservation of the structures.

Published
2021

2. Progetto SOPHY: Studio osservazionale sul pH vaginale e sullo stile di vita della donna nelle diverse età e condizioni fisiopatologiche. Parte I

Author

Guaschino, S., Benvenuti, C., Agnello, A., Agnolotti, M., Agostinelli, D., Agrifoglio, V., Albani, F., Alesi, L., Amadori, A., Andresini, R., Anelli, R., Antoniello, M., Arcadia, P., Arduino, S., Atlante, M., Bagnara, M., Balestrucci, G., Barbini, V., Barletta, F., Bassan, M., Bechini, F., Belsan, R., Benatti, G., Beretta, R., Bernardi, F., Bersani, R., Bertocchi, L., Bianchi, M. S., Bianchi, S., Biello, A., Bolelli, E., Bonaccorsi, G., Bonauguri, F., Bondesan, A., Bordignon, D., Bozzo, G., Brambilla, T., Brizio, A. M., Brusa, C., Businco, F., Cadario Preti, E., Calanchini, C., Capodieci, C., Cardinale, A., Carnio, P., Carnuccio, G., Casa, A., Castagna, P., Cazzavacca, R., Chiodi, A., Ciancio, G., Ciccone, E., Cicotti, M. P., Cino, S., Cirri, R., Citterio, S., Colla, F., Colombi, C., Conti, C. S., Corazza, G., Crana, F., Creanza, V., Crisafulli, M. L., Cristiani, P., Cugini, A. M., Curto, G., Cutuli, A., Dal Bò, R., Damone, R., De Majo, D., De Nuzzo, M. A., De Rosa, E., De Valle Vietti, G., Defazio, D. D., Delli Ponti, E. C., Di Bari, I., Di Biase, R., Di Cosmo, E., Di Giovinazzo, L., Di Natale, R., Di Pietro, F., Esposito, E., Fabbrizi, L., Faggionato, I., Fanti, S., Favi, O., Fazio Pellacchio, C., Ferraina, F., Ferrari, D., Ferrentino, A., Fiscella, A., Fischetti, A., Florio, V., Forcella, G., Franzolini, P., Furani, S., Fuschini, G., Gallo, G., Gammi, L., Geda, O., Gianfranceschi, C., Gigante, A., Giolito, M. R., Giordano, A., Giovagnorio, P., Giuliani, L., Gostinicchi, P., Gozeni, M., Guadalupi, E., Guagliarlo, M., Guastaferro, L., Gubbiotti, R., Guernieri, A., Guidi, A., Guzzinati, N., Iannacci, M. C., Iannelli, S., Infante, F. E., Insacco, P., Jannacone, D., Lalanne, A., Lanfranchi, A., Latella, R., Lazzarin, L., Lefosse, M. G., Lemme, E., Lepadatu, C., Levanti, S., Liberio, M. D., Linsalata, I., Lombardi, P., Luchi, C., Lucianetti, M., Luciano, V., Maccarini, U., Maggio, I., Maggiorelli, M., Maietta, A., Mancini, A. C., Mancini, L., Mancini, F., Manni, M. U., Manuzio, D., Manzan, L., Marasca, O., Marchi, M., Marcozzi, S., Maresi, M. P., Mariatti, M., Martinelli, P., Masi, P., Masini, M., Massa, E., Matanã², S., Mattioli, V., Mazzoli, F., Mazzucato, R., Medori, A., Melappioni, S., Mendolicchio, S., Meroni, S., Miliffi, L., Minorini, D., Mirra, P., Mori, R., Moroni, S., Mossetti, M., Motta, N., Mucci, M., Munizza, W., Mura, M., Musconi, M., Mussida, M., Nanni, C., Nardi, E., Nardi, M., Nesi, D., Nirta, A., Nozza, M., Oliva, N., Oliverio, C., Onofri, M. C., Paduano, F., Palombino, K., Papadia, L. S., Parvaneh, H., Pascazio, F., Pasini, T., Pasini, A., Paticchio, M. R., Pellegrinotti, A., Pensabene, I., Perilli, M. L., Perrini, G., Perugini, A., Pessina, M., Petracchi, M., Pieracci, R., Pignata, M., Pisaturo, G., Po, E., Poggi, M. G., Poli, M., Polpatelli, L., Pone, A., Ponticelli, R., Potenza, M. T., Previdi, A. M., Preziuso, M., Quagliarini, V., Quaranta, M., Quattrocchi, G., Ragusa, S., Rainã², M. I., Regge, G. M., Rizzo, S., Roberti, P., Romano, G., Romano, D., Rossi, M., Ruggeri, C., Ruggiero, G., Russo, C., Russotto, C. M., Salmi, P., Salvestroni, C., Salviato, M. G., Sangiorgi, B., Santandrea, V., Santomauro, S., Santoni, S., Sarica, F., Savoca, S., Scandellari, E., Scarpellini, M., Sciarra, M. N., Scibilia, M. R., Scopacasa, P., Serafini, T., Setaccioli, M., Settembrini, L., Sganga, E., Simionato, S., Sommacampagna, P., Spadaro, F., Spettoli, D. A., Speziale, M., Spiga, A. M., Stampone, R., Stefanidou, M., Stefanutti, B., Stolfi, G., Strazzari, G., Tabanelli, S., Tafuri, A., Tamburini, M., Tampucci, S., Tarantini, P., Tempesta, N., Testoni, N., Testori, P., Tomba, D., Toscano, M., Trapassi, L., Tripodi, M., Vadalã , A., Valentino, V., Valieri, M., Valsecchi, L., Vassena, L., Ventimiglia, L., Vicentini, M. T., Volonterio, A. M., Votano, S., Wittemberg, L., Zangara, C., Zecchi, R., ORIGONI, MASSIMO, Guaschino, S., Benvenuti, C., Agnello, A., Agnolotti, M., Agostinelli, D., Agrifoglio, V., Albani, F., Alesi, L., Amadori, A., Andresini, R., Anelli, R., Antoniello, M., Arcadia, P., Arduino, S., Atlante, M., Bagnara, M., Balestrucci, G., Barbini, V., Barletta, F., Bassan, M., Bechini, F., Belsan, R., Benatti, G., Beretta, R., Bernardi, F., Bersani, R., Bertocchi, L., Bianchi, M. S., Bianchi, S., Biello, A., Bolelli, E., Bonaccorsi, G., Bonauguri, F., Bondesan, A., Bordignon, D., Bozzo, G., Brambilla, T., Brizio, A. M., Brusa, C., Businco, F., Cadario Preti, E., Calanchini, C., Capodieci, C., Cardinale, A., Carnio, P., Carnuccio, G., Casa, A., Castagna, P., Cazzavacca, R., Chiodi, A., Ciancio, G., Ciccone, E., Cicotti, M. P., Cino, S., Cirri, R., Citterio, S., Colla, F., Colombi, C., Conti, C. S., Corazza, G., Crana, F., Creanza, V., Crisafulli, M. L., Cristiani, P., Cugini, A. M., Curto, G., Cutuli, A., Dal Bò, R., Damone, R., De Majo, D., De Nuzzo, M. A., De Rosa, E., De Valle Vietti, G., Defazio, D. D., Delli Ponti, E. C., Di Bari, I., Di Biase, R., Di Cosmo, E., Di Giovinazzo, L., Di Natale, R., Di Pietro, F., Esposito, E., Fabbrizi, L., Faggionato, I., Fanti, S., Favi, O., Fazio Pellacchio, C., Ferraina, F., Ferrari, D., Ferrentino, A., Fiscella, A., Fischetti, A., Florio, V., Forcella, G., Franzolini, P., Furani, S., Fuschini, G., Gallo, G., Gammi, L., Geda, O., Gianfranceschi, C., Gigante, A., Giolito, M. R., Giordano, A., Giovagnorio, P., Giuliani, L., Gostinicchi, P., Gozeni, M., Guadalupi, E., Guagliarlo, M., Guastaferro, L., Gubbiotti, R., Guernieri, A., Guidi, A., Guzzinati, N., Iannacci, M. C., Iannelli, S., Infante, F. E., Insacco, P., Jannacone, D., Lalanne, A., Lanfranchi, A., Latella, R., Lazzarin, L., Lefosse, M. G., Lemme, E., Lepadatu, C., Levanti, S., Liberio, M. D., Linsalata, I., Lombardi, P., Luchi, C., Lucianetti, M., Luciano, V., Maccarini, U., Maggio, I., Maggiorelli, M., Maietta, A., Mancini, A. C., Mancini, L., Mancini, F., Manni, M. U., Manuzio, D., Manzan, L., Marasca, O., Marchi, M., Marcozzi, S., Maresi, M. P., Mariatti, M., Martinelli, P., Masi, P., Masini, M., Massa, E., Matanã², S., Mattioli, V., Mazzoli, F., Mazzucato, R., Medori, A., Melappioni, S., Mendolicchio, S., Meroni, S., Miliffi, L., Minorini, D., Mirra, P., Mori, R., Moroni, S., Mossetti, M., Motta, N., Mucci, M., Munizza, W., Mura, M., Musconi, M., Mussida, M., Nanni, C., Nardi, E., Nardi, M., Nesi, D., Nirta, A., Nozza, M., Oliva, N., Oliverio, C., Onofri, M. C., Origoni, Massimo, Paduano, F., Palombino, K., Papadia, L. S., Parvaneh, H., Pascazio, F., Pasini, T., Pasini, A., Paticchio, M. R., Pellegrinotti, A., Pensabene, I., Perilli, M. L., Perrini, G., Perugini, A., Pessina, M., Petracchi, M., Pieracci, R., Pignata, M., Pisaturo, G., Po, E., Poggi, M. G., Poli, M., Polpatelli, L., Pone, A., Ponticelli, R., Potenza, M. T., Previdi, A. M., Preziuso, M., Quagliarini, V., Quaranta, M., Quattrocchi, G., Ragusa, S., Rainã², M. I., Regge, G. M., Rizzo, S., Roberti, P., Romano, G., Romano, D., Rossi, M., Ruggeri, C., Ruggiero, G., Russo, C., Russotto, C. M., Salmi, P., Salvestroni, C., Salviato, M. G., Sangiorgi, B., Santandrea, V., Santomauro, S., Santoni, S., Sarica, F., Savoca, S., Scandellari, E., Scarpellini, M., Sciarra, M. N., Scibilia, M. R., Scopacasa, P., Serafini, T., Setaccioli, M., Settembrini, L., Sganga, E., Simionato, S., Sommacampagna, P., Spadaro, F., Spettoli, D. A., Speziale, M., Spiga, A. M., Stampone, R., Stefanidou, M., Stefanutti, B., Stolfi, G., Strazzari, G., Tabanelli, S., Tafuri, A., Tamburini, M., Tampucci, S., Tarantini, P., Tempesta, N., Testoni, N., Testori, P., Tomba, D., Toscano, M., Trapassi, L., Tripodi, M., Vadalã , A., Valentino, V., Valieri, M., Valsecchi, L., Vassena, L., Ventimiglia, L., Vicentini, M. T., Volonterio, A. M., Votano, S., Wittemberg, L., Zangara, C., and Zecchi, R.

Subjects
Sexual behavior, Vagina, secretion, Vaginosis, bacterial, Obstetrics and Gynecology, Candida
Abstract

Aim. The importance of vaginal pH and vaginal flora in maintaining a well-balanced vaginal ecosystem is well known and has been widely described. However, no systematic nationwide studies have been carried out concerning the correlation between vaginal pH, life style and different physiopathological conditions in women of different ages. Methods. SOPHY (Study on pH and Hygiene) collected data concerning the lifestyle, vaginal pH, and the presence of symptoms, stratified into different subgroups (prepuberal, fertile, pregnancy, postpartum, premenopause and menopause) in a representative sample of the Italian gynecological population (264 gynaecologists for a total of 2 641 women) with the aid of a specific Internet site for data entry. Results. A more acid vaginal pH was related to a better satisfactory sexual activity and to more healthy genital condition. A positive relationship was detected between education level and good perception of sexuality. Certain clothing habits and a higher frequency of candidiasis and bacterial vaginosis was shown. Conclusion. SOPHY revealed some interesting correlations between clothing and the frequency of candidiasis and bacterial vaginosis, between vaginal pH and satisfactory sexual activity, and between education and sexuality. SOPHY had a considerable educational impact, leading the physicians and women to consider vaginal pH as an important aspect of everyday life.

Published
2008

3. Assessment of risk factors and human papillomavirus (HPV) related pathogenetic mechanisms of CIN in HIV-positive and HIV-negative women

Author

Branca, M, Costa, S, Mariani, L, Sesti, F, Agarossi, A, DI CARLO, A, Galati, M, Benedetto, A, Ciotti, M, Giorgi, C, Criscuolo, A, Valieri, M, Favalli, C, Paba, P, Santini, D, Piccione, E, Alderisio, M, DE NUZZO, M, DI BONITO, Luigi, Syrjanen, K., Branca, M, Costa, S, Mariani, L, Sesti, F, Agarossi, A, DI CARLO, A, Galati, M, Benedetto, A, Ciotti, M, Giorgi, C, Criscuolo, A, Valieri, M, Favalli, C, Paba, P, Santini, D, Piccione, E, Alderisio, M, DE NUZZO, M, DI BONITO, Luigi, and Syrjanen, K.

Published
2004

4. Assessment of risk factors and human papillomavirus (HPV) related pathogenetic mechanisms of CIN in HIV-positive and HIV-negative women. Study design and baseline data of the HPV-PathogenISS study

Author

Branca, M., Costa, S., Mariani, L., Sesti, F., Agarossi, A., Aldo Di Carlo, Galati, M., Benedetto, A., Ciotti, M., Giorgi, C., Criscuolo, A., Valieri, M., Favalli, C., Paba, P., Santini, D., Piccione, E., Alderisio, M., Nuzzo, M., Di Bonito, L., and Syrjänen, K.

Subjects
Adult, HPV, Interaction, Uterine Cervical Neoplasms, HIV Infections, Pathogenesis, Polymerase Chain Reaction, Cohort Studies, 80 and over, Humans, Viral, Prospective Studies, Cervical Intraepithelial Neoplasia, CIN, Papillomaviridae, Retrospective Studies, Aged, DNA Primers, Papillomavirus Infections, HIV, DNA, Middle Aged, Settore MED/07 - Microbiologia e Microbiologia Clinica, Tumor Virus Infections, Italy, Risk factors, Colposcopy, Intermediate endpoint markers, Pap smear, Female, Settore MED/40 - Ginecologia e Ostetricia, DNA, Viral, Aged, 80 and over, Risk Factors

5. SOPHY project: An observational study of vaginal pH, lifestyle and correct intimate hygiene in women of different ages and in different physiopathological conditions. Part II | Progetto SOPHY: Studio osservazionale su pH vaginak, stile di vita e corretta igiene intima nella donna nelle diverse eta e condizioni fisiopatologiche. Parte II

Author

Guaschino, S., Benvenuti, C., Agnello, A., Agnolotti, M., Agostinelli, D., Agrifoglio, V., Albani, F., Alesi, L., Amadori, A., Andresini, R., Anelli, R., Antoniello, M., Arcadia, P., Arduino, S., Atlante, M., Bagnara, M., Balestrucci, G., Barbini, V., Barletta, F., Bassan, M., Bechini, F., Belsan, R., Benatti, G., Beretta, R., Bernardi, F., Bersani, R., Bertocchi, L., Bianchi, M. S., Bianchi, S., Biello, A., Bolelli, E., Bonaccorsi, G., Bonauguri, F., Bondesan, A., Bordignon, D., Bozzo, G., Brambilla, T., Brizio, A. M., Brusa, C., Businco, F., Cadario Preti, E., Calanchini, C., Capodieci, C., Cardinale, A., Camio, P., Carnuccio, G., Casa, A., Castagna, P., Cazzavacca, R., Chiodi, A., Ciancio, G., Ciccone, E., Cicotti, M. P., Cino, S., Cirri, R., Citterio, S., Colla, F., Colombi, C., Conti, C. S., Corazza, G., Crana, F., Creanza, V., Crisafulli, M. L., Cristiani, P., Cugini, A. M., Curto, G., Cutuli, A., Dal Bo, R., Damone, R., Majo, D., Nuzzo, M. A., Rosa, E., Valle-Vietti, G., Defazio, D. D., Delli Ponti, E. C., Di Bari, I., Di Biase, R., Di Cosmo, E., Di Giovinazzo, L., Di Natale, R., Di Pietro, F., Esposito, E., Fabbrizi, L., Faggionato, I., Fanti, S., Favi, O., Fazio-Pellacchio, C., Ferraina, F., Ferrari, D., Ferrentino, A., Fiscella, A., Fischetti, A., Florio, V., Forcella, G., Franzolini, P., Furani, S., Fuschini, G., Gallo, G., Gammi, L., Geda, O., Gianfranceschi, C., Gigante, A., Giolito, M. R., Giordano, A., Giovagnorio, P., Giuliani, L., Gostinicchi, P., Gozeni, M., Guadalupi, E., Guagliarlo, M., Guastaferro, L., Gubbiotti, R., Guemieri, A., Guidi, A., Guzzinati, N., Iannacci, M. C., Iannelli, S., Infante, F. E., Insacco, P., Jannacone, D., Lalanne, A., Lanfranchi, A., Latella, R., Lazzarin, L., Lefosse, M. G., Lemme, E., Lepadatu, C., Levanti, S., Liberio, M. D., Linsalata, I., Lombardi, P., Luchi, C., Lucianetti, M., Luciano, V., Maccarini, U., Maggio, I., Maggiorelli, M., Maietta, A., Mancini, A. C., Mancini, L., Mancini, F., Manni, M. U., Manuzio, D., Manzan, L., Marasca, O., Marchi, M., marco onofrj, Maresi, M. P., Mariatti, M., Martinelli, P., Masi, P., Masini, M., Massa, E., Malanò, S., Mattioli, V., Mazzoli, F., Mazzucato, R., Medori, A., Melappioni, S., Mendolicchio, S., Meroni, S., Miliffi, L., Minorini, D., Mirra, P., Mori, R., Moroni, S., Mossetti, M., Motta, N., Mucci, M., Munizza, W., Mura, M., Musconi, M., Mussida, M., Nanni, C., Nardi, E., Nardi, M., Nesi, D., Nirta, A., Nozza, M., Oliva, N., Oliverio, C., Onofri, M. C., Origoni, M., Paduano, F., Palombino, K., Papadia, L. S., Parvaneh, H., Pascazio, F., Pasini, T., Pasini, A., Paticchio, M. R., Pellegrinotti, A., Pensabene, I., Perilli, M. L., Perrini, G., Perugini, A., Pessina, M., Petracchi, M., Pieracci, R., Pignata, M., Pisaturo, G., Po, E., Poggi, M. G., Poli, M., Polpatelli, L., Pone, A., Ponticelli, R., Potenza, M. T., Previdi, A. M., Preziuso, M., Quagliarini, V., Quaranta, M., Quattrocchi, G., Ragusa, S., Rainò, M. I., Regge, G. M., Rizzo, S., Roberti, P., Romano, G., Romano, D., Rossi, M., Ruggeri, C., Ruggiero, G., Russo, C., Russotto, C. M., Salmi, P., Salvestroni, C., Salviato, M. G., Sangiorgi, B., Santandrea, V., Santomauro, S., Santoni, S., Sarica, F., Savoca, S., Scandellari, E., Scarpellini, M., Sciarra, M. N., Scibilia, M. R., Scopacasa, P., Serafini, T., Setaccioli, M., Settembrini, L., Sganga, E., Simionato, S., Sommacampagna, P., Spadaro, F., Spettoli, D. A., Speziale, M., Spiga, A. M., Stampone, R., Stefanidou, M., Stefanutti, B., Stolfi, G., Strazzari, G., Tabanelli, S., Tafuri, A., Tamburini, M., Tampucci, S., Tarantini, P., Tempesta, N., Testoni, N., Testori, P., Tomba, D., Toscano, M., Trapassi, L., Tripodi, M., Vadala, A., Valentino, V., Valieri, M., Valsecchi, L., Vassena, L., Ventimiglia, L., Vicentini, M. T., Volonterio, A. M., Votano, S., Wittemberg, L., Zangara, C., and Zecchi, R.

7. A Fog Computing Orchestrator Architecture with Service Model Awareness

Author

Gianluca Davoli, Walter Cerroni, Davide Borsatti, Mario Valieri, Daniele Tarchi, Carla Raffaelli, Davoli G., Cerroni W., Borsatti D., Valieri M., Tarchi D., and Raffaelli C.

Subjects
Data model, Computer Networks and Communications, Computational modeling, Dynamic scheduling, Edge computing, Fog Computing, experimental testbed, Numerical model, service deployment, Cloud computing, service orchestration, Computer architecture, Electrical and Electronic Engineering, XaaS
Abstract

Fog Computing can facilitate the adoption of the Everything-as-a-Service paradigm in infrastructure segments that are located closer to the end user, or to the data source, compared to typical Cloud solutions. This enables combining the advantages of flexible service deployment models with the need to cope with the strict requirements – especially in terms of latency – of emerging applications in softwarized networks. Along comes the need to consider aspects of service orchestration specific to the Fog environment and its intrinsically dynamic nature. In this paper we propose an architecture for flexible Fog Computing service orchestration, with a particular focus on the awareness of service deployment models. We discuss the design choices and describe the components and operations of the proposed orchestration system. We then present a complete working implementation of such architecture, including insights on its ability to handle critical orchestration functions such as service discovery and resource monitoring. We also report on the experimental validation of the system and the performance evaluation on real-world equipment, proving the feasibility and the effectiveness of the approach on a dynamic Fog infrastructure. We complement the work by presenting the results of a combinatorial analysis, validated by simulation, of the service model-aware resource selection process. As a result of our investigation, we show that Fog services can be effectively deployed in a matter of a few seconds, or even in less than one second when suitable Fog nodes are available, taking advantage of the awareness of the available service models.

Published
2022

8. Surgical treatment of class II malocclusion in the orthodontic boundaries: a case report.

Author

Bandeca MC, Porto AN, Valieri S, Valieri M, Borges AH, and Mattos FZ

Subjects
Bicuspid surgery, Esthetics, Dental, Female, Humans, Malocclusion, Angle Class II therapy, Mandibular Advancement methods, Osteotomy, Sagittal Split Ramus methods, Tooth Extraction, Tooth Movement Techniques methods, Treatment Outcome, Young Adult, Malocclusion, Angle Class II surgery, Orthognathic Surgical Procedures methods
Abstract

The aim of this study was to report a clinical case of treatment of Class II division I malocclusion with facial aesthetic impairment, whose therapeutic approach comprised the association of orthodontic treatment with orthognathic surgery. The treatment for the present case consisted of decompensation oflower incisors and extraction oftwo lower premolars, in order to obtain horizontal discrepancy allowing the surgery for mandibular advancement. At the end of treatment, we could clinically observe a Class I molar/canine relationship, normal overbite and overjet, presence of lip seal, type I facial profile with considerable aesthetic improvement. We can conclude that the ortho-surgical treatment is a therapeutic alternative providing the best prognosis in terms of aesthetic correction in patients with unpleasant facial profile.

Published
2014

9. Assessment of risk factors and human papillomavirus (HPV) related pathogenetic mechanisms of CIN in HIV-positive and HIV-negative women. Study design and baseline data of the HPV-PathogenISS study.

Author

Branca M, Costa S, Mariani L, Sesti F, Agarossi A, di Carlo A, Galati M, Benedetto A, Ciotti M, Giorgi C, Criscuolo A, Valieri M, Favalli C, Paba P, Santini D, Piccione E, Alderisio M, De Nuzzo M, di Bonito L, and Syrjänen K

Subjects
Adult, Aged, Aged, 80 and over, Cohort Studies, DNA Primers, DNA, Viral analysis, Female, Humans, Italy epidemiology, Middle Aged, Papillomaviridae genetics, Papillomavirus Infections etiology, Polymerase Chain Reaction, Prospective Studies, Retrospective Studies, Risk Factors, Tumor Virus Infections etiology, Uterine Cervical Neoplasms etiology, Uterine Cervical Dysplasia etiology, HIV Infections, Papillomaviridae isolation & purification, Papillomavirus Infections epidemiology, Tumor Virus Infections epidemiology, Uterine Cervical Neoplasms epidemiology, Uterine Cervical Dysplasia epidemiology
Abstract

Objectives: In women with HIV-associated immunosuppression, HPV infections have an increased risk of progression to high-grade cervical intraepithelial neoplasia (CIN). With the HAART-induced prolonged survival and more protracted clinical course of AIDS, progression of CIN to cervical cancer (CC) has become a clinically relevant issue, and the mechanisms responsible for HIV-HPV interactions need further elucidation. The study design and analysis of the baseline data of our new project are presented., Material and Methods: This project is a combination of a prospective cohort study of HIV- and HIV+ women, and a retrospective analysis of CIN lesions and cervical cancer. Up to the present, 244 women have been enrolled (17 HIV+) and subjected to epidemiological interview, colposcopic examination, sampling for HPV testing and typing (PCR, InnoLiPA), and HPV serology. The retrospective series of biopsies were analysed for 13 biomarkers (monitoring key molecular events) using immunohistochemistry and tested for HPV by PCR and TaqMan., Results: HIV- and HIV+ women differ in their exposure status to many of the key epidemiological risk factors of cervical cancer, the most significant ones being number of sexual partners (p = 0.0001), age at onset of sexual activity (p = 0.002), and contraception (yes-no) (p = 0.009). The differences in the baseline clinical observations are less dramatic; HIV-positive women had more frequent HSIL PAP tests (p = 0.040), CIN2 or higher in cervical biopsy (p = 0.049), and external genital warts (p = 0.019). The factors predicting intermediate endpoint markers of cervical cancer, i.e., HSIL PAP smear, ATZ2 in colposcopy, and high-grade CIN in biopsy were analysed in univariate and multivariate regression models. All factors significant in univariate analysis were entered in the multivariate model; HIV-status and Pap smear history maintained their independent predictive power of the HSIL Pap test. The most powerful predictor of ATZ2 colposcopy was HSIL in Pap test. Only the HSIL Pap test and ATZ2 colposcopy remained significant independent predictors of high-grade CIN (p = 0.0001 and p = 0.008, respectively) in the multivariate model., Conclusions: The three intermediate endpoint markers are closely interrelated, but predicted in part by different covariantes in the causal pathway to cervical cancer. To elucidate whether the increased risk of HIV-positive women to high-grade CIN is due a) to their different exposure status to the risk factors, b) to the direct effects of HIV, or c) to molecular interactions between HIV and HPV, we need to complete these analyses separately in HIV+ and HIV- women.

Published
2004

10. Mucosal immune response to Human Papilloma Virus (HPV) infection in HIV positive women.

Author

Agarossi A, Casolati E, Valieri M, Ferrazzi E, Maffeis G, Trabattoni D, and Clerici M

Subjects
Down-Regulation immunology, Female, Humans, Immunity, Mucosal, Papillomaviridae, Genitalia, Female immunology, HIV Seropositivity complications, Papillomavirus Infections complications, Papillomavirus Infections immunology
Abstract

Mucosal immunity plays a central role in the control of genital human papilloma virus (HPV) infection. HIV infection is associated with higher risks of HPV-induced neoplasias. Prevalence, incidence and evolution of genital HPV lesions are correlated with the level of immunodepression. Several changes of the local immune response in the genital tract of HIV infected women have been demonstrated. The influence of HIV on the production of some immunoregulatory cytokines appears of particular interest. The shift from the helper T cells type 1 (Th1) to the helper T cells type 2 (Th2) immune response, which determines the downregulation of the cell-mediated immunity, may explain the frequent loss of immunologic control of HPV and its oncological complications

Published
2003

11. Vulvar neoplasia in HIV positive women: a review.

Author

Casolati E, Agarossi A, Valieri M, and Ferrazzi E

Subjects
Antiretroviral Therapy, Highly Active, Female, Humans, Papillomaviridae, Risk Factors, Carcinoma in Situ diagnosis, Carcinoma in Situ virology, HIV Seropositivity complications, Papillomavirus Infections complications, Vulvar Neoplasms diagnosis, Vulvar Neoplasms virology
Abstract

Among genital malignancies, vulvar cancer and its precursor, Vulvar Intraepithelial Neoplasia (VIN), is less commonly encountered than cervical neoplasia. According to R.W. Jones (2001) vulvar cancer represents about 3-5% of all genital neoplasms and its peak of incidence is between 60 and 80 years of age. Risk factors for vulvar carcinoma are: smoking and immune depression, which expose to a higher risk of vulvar HPV infection caused by high risk strains. In recent years, increased prevalence and incidence of high grade VIN and vulvar invasive carcinoma in young patients (below 45 years of age) have been reported. The main group of affected cases is represented by HIV infected women. Data about the severity of immune depression, expressed by CD4 cell count, as an adjunctive risk factor for persistence, recurrence or progression, are conflicting and scanty. Moreover, information about the effect of Highly Active Antiretroviral Therapy (HAART) on the natural history of VIN are inconclusive. So far, a thorough examination of the vulvar region, associated with colposcopy and biopsy when indicated, should be considered a routine procedure in the gynaecological surveillance of HIV positive women.

Published
2003

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