G. Gessoni

Civil Hospital, Raikot, Rāikot, Punjab, India

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Publications (78)84.71 Total impact

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    ABSTRACT: Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal nonneoplastic hematopoietic stem cell disease characterized by an acquired mutation of the PIG-A gene with reduction or absence of CD55 and CD59. The absence of these proteins renders PNH erythrocytes susceptible to complement-mediated hemolysis. We report the case of a PNH patient before and during pregnancy until delivery. We observed and treated some postpartum thrombotic complications. Eculizumab should be used with caution in pregnancy. There are several reports supporting its use in these patients. This case should be considered paradigmatic of a series of clinical situations that may occur in the course of a pregnancy in patients with PNH: increased need for transfusion, need to increase the dose of Eculizumab, and insurgence of fetal sufferance. Moreover, after delivery, the patient, despite adequate prophylaxis with low-molecular-weight heparins, presented severe complications: development of pleural and peritoneal effusion, pulmonary embolism, bilateral upper limbs thrombophlebitis, and a possible abdominal angina with a transient paralytic ileus. All these complications were overcome and now the baby is healthy and the mother has returned to the usual therapeutic regimen.
    No preview · Article · Feb 2015 · Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis
  • Gianluca Gessoni · Sara Valverde · Francesca Gessoni · Roberto Valle

    No preview · Article · Jan 2015 · Blood transfusion = Trasfusione del sangue
  • G. Gessoni · S. Valverde · R. Valle
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    ABSTRACT: We present a report about the interference due to factor IIa and factor Xa direct oral inhibitors on activated C protein resistance ratio (APCr), evaluated with a prothrombinase-based assay, in a patient heterozygous for factor V Leiden treated first with dabigatran and then with rivaroxaban. In this patient dabigatran increased the APCr ratio to a degree compatible with values observed in homozygous wild-type carriers, thus causing a potential misdiagnosis. We also found that rivaroxaban therapy was effective in lowering the APCr ratio.
    No preview · Article · Jan 2015 · Biochimica clinica
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    ABSTRACT: Urine culture is the most frequently requested test for a Microbiology Lab. A reliable screening tool would be of paramount importance both to clinicians and laboratorians, provided that it could get fast and accurate negative results in order to rule-out urinary tract infection (UTI). We evaluated 1907 consecutive urine samples from outpatients. Culture was performed on chromogenic agar with 1μL loop, using 10(5)CFU/mL as a limit of positive growth. Using Sysmex Uf-1000i analyzer we evaluated bacteria forward scatter (B_FSC) and fluorescent light scatter (B_FLH) in a preliminary discrimination step for UTI caused by Gram+ or Gram- bacteria. We got 512 positive samples. A mono-microbial infection was observed in 490 samples; two bacterial strains were isolated in 22 samples, so 534 bacterial strains were found: 392 Gram-, 133 Gram+ and 9 yeasts. Comparing Gram+ and Gram- bacteria we observed a statistically significant difference for B_FSC but not for B_FLH. In this application experimental cut-off value for B_FSC was 25ch. Using this cut-off to perform a presumptive identification of UTI sustained by Gram-+ bacteria, we observed a SE 0.68, SP 0.84. Our data although preliminary suggest that B_FSC could be useful in presumptive exclusion of UTI caused by Gram-positive bacteria. Copyright © 2014. Published by Elsevier B.V.
    No preview · Article · Nov 2014 · Clinica Chimica Acta
  • G. Saccani · G. Gessoni · S. Valverde · F. Manoni · M. Visconti
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    ABSTRACT: Urine culture is the most frequent test in microbiology laboratories. A screening tool, providing fast and reliable results to rule-out urinary tract infection (UTI), would be of great importance. We studied 1043 consecutive urine samples by Sysmex UF-1000i analyzer. Comparison was made by robotic urine culture on chromogenic agar with 1 μL loop, using 105 CFU/mL as a limit of positive growth. We evaluated bacteria quantification for rapid exclusion of UTI and bacteria forward scatter (B-FSC) in preliminary discrimination of UTI caused by Gram positive or Gram negative bacteria. For exclusion of UTI, the best cut-off value was 130 bacteria/μL. At this threshold, the sensitivity (SE) was 0.98 and the specificity (SP) 0.75. For exclusion of UTI sustained by Gram positive bacteria, the best cut-off value for B-FSC was 25ch. At this threshold, SE was 0.68 and SP was 0.89.
    No preview · Article · Jan 2014
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    ABSTRACT: Acquired hemophilia A (AHA) is a rare, but often life-threatening hemorrhagic disorder characterized by antibodies directed against coagulation factor VIII. We report clinical and laboratory investigations of two cases with AHA observed in our hospital. These patients were two elderly women (73 and 62 years old), who presented with subcutaneous bleeding, intramuscular hematoma and a prolonged activated partial thromboplastin time (aPTT). On the basis of these findings as well as decreased factor VIII activities and the presence of factor VIII inhibitors, we made a diagnosis of AHA. Both patients were referred to a specialized hospital for treatment. The diagnosis of AHA should be considered in any elderly patient who presents with bleeding and prolonged aPTT. Moreover, the coexistence of a series of underlying diseases associated with AHA should be always searched for.
    No preview · Article · Dec 2013 · Biochimica clinica
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    ABSTRACT: We performed a multicenter study to calculate the upper reference limits (URL) for urine particle quantification in mid-stream samples by using automated urine analyzers. Two laboratories tested 283 subjects using a Sysmex UF-100, two other laboratories tested 313 subjects using Sysmex UF-1000i, whereas two other laboratories tested 267 subjects using Iris IQ®200. The URLs of UF-100 in females and males were 7.8/μL and 6.7/μL for epithelial cells (EC), 11.1/μL and 9.9/μL for red blood cells (RBC), 10.2/μL and 9.7/μL for white blood cells (WBC), and 0.85/μL and 0.87/μL for cylinders (CAST). The URLs of UF-1000i in females and males were 7.6/μL and 7.1/μL for EC, 12.2/μL and 11.1/μL for RBC, 11.9/μL and 11.7/μL for WBC, and 0.88/μL and 0.86/μL for CAST. The URLs of Iris IQ®200 in females and males were 7.8/μL and 6.6/μL for EC, 12.4/μL and 10.1/μL for RBC, 10.9/μL and 9.9/μL for WBC, and 1.1/μL and 1.0/μL for CAST. The URLs obtained in this study were comparable to the lowest values previously reported in the literature. Moreover, no gender-related difference was observed, and analyzer-specific upper reference limits were very similar.
    No preview · Article · Sep 2013 · Clinica chimica acta; international journal of clinical chemistry
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    ABSTRACT: The purpose of this Italian multicenter study was to define pediatric upper references values for urine particles quantification by using automated flow cytometry. Design and Methods Four hospital-based clinical laboratories participated to this multicenter investigation, which included a total study population of 161 Italian children aged from 1 to 12years. Two laboratories used Sysmex UF-100 and analyzed 86 children, whereas the other two used Sysmex UF-1000i and analyzed 75 subjects. Particles quantification included the analysis of white blood cells (WBC), red blood cells (RBC), squamous epithelial cells (EC), transitional epithelial cells (TC), casts (CAST) and bacteria (BACT). The upper references values in subjects tested with the Sysmex UF-100 were 9.7 WBC/μL, 10.1 RBC/μL, 7.5 EC/μL, 2.5 TC/μL, 0.7 CAST/μL and 3090 BACT/μL, whereas the upper reference values in subjects tested with Sysmex UF-1000i were 10.5 WBC/μL, 8.3 RBC/μL, 7.2 EC/μL, 2.9 TC/μL, 0.7 CAST/μL, 48 BACT/μL. No statistically significant differences between genders were found in the value distribution of any of the parameter tested. Similarly, no statistically significant differences were observed between the two urine analyzers, except for BACT. Automated analysis of urine particles appears a suitable means to optimize the workflow of routine urinalysis of children specimens. The upper reference limits for pediatric subjects obtained in this study were comparable to those previously reported in the literature, with no significant differences between genders and analyzers.
    No preview · Article · Sep 2013 · Clinical biochemistry
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    ABSTRACT: In type 3 polyendocrine syndrome (PAS3), autoimmune thyroiditis occurs with other organ-specific autoimmune disease, but not with autoimmune adrenalitis. In this report we described a family from Pakistan in which mother and three daughters were affected by a PAS3. We studied a family from Pakistan: Father MMu age 44, mother KN aged 44, three daughters MM age 20, MH age 16 and MA age 14 and a son MU age 18. These subjects were tested for thyroids function, metabolic function, adrenal function, autoimmune disease. In this family the four females were shown hypothyroidism with presence of anti thyroid autoantibodies (AA) and high TSH serum concentration in association with the presence of anti transglutaminase AA. Moreover KN, MM and MH were positive for anti nuclear AA (granular pattern) and for antibodies against Saccaromyces cerdevisiae. MM was positive for AA against nuclear extractable antigens (SSA and SSB) too. No diabetes or pernicious anemia were observed. Adrenal and Pituitary function were normal. PAS 3C is an uncommon disease. In this family from Pakistan we observed a PAS3C in the four female members: mother and three daughters while father and son were unaffected.
    No preview · Article · Sep 2013 · Minerva endocrinologica
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    ABSTRACT: Background. FVG1691A (factor V Leiden, FVL) and FII G20210A (prothrombin G, GPRO) polymorphisms are the most common genetic causes of thrombophilia. For diagnosis of these polymorphisms, two years ago we adopted the GeneXpert instrument, after a preliminary study conducted on frozen plasma that had already been typed. We report our experience concerning the routine application of this analysis system. Methods. Between January 2011 and December 2012, 1106 patients were evaluated for detection of FVL and GPRO using the Cepheid GeneXpert system (Instrumentation Laboratory, Milan, Italy). The first 142 were also tested with the LightCycler system (Roche, Monza, MI, Italy). Results. Results obtained with the GeneXpert system showed full agreement with those obtained with the LightCycler system. Full agreement was also observed with previously characterized frozen samples. Among the 1,106 subjects examined, 235 were FVL heterozygous, 20 homozygous FVL, 37 GPRO heterozygous, 3 homozygous GPRO, 15 double heterozygous FVL/GPRO, and 796 genetically normal. In the 2-year period we observed only 37 invalid results with the need to repeat the test. Conclusions. The GeneXpert system is a fully automated analytical system. In less than 35 minutes, it is possible to perform a combined determination of FVL and GPRO from a subject’s anticoagulated whole blood. The design of the kit, based on the use of individual disposable cartridges, in which are contained all the necessary reagents for the extraction of nucleic acids, their amplification and the detection of the amplicons, eliminates waste and allows determinations to be performed on demand. On the other hand, the extremely simple manual makes the test accessible to those laboratories not specializing in molecular biology techniques. In our experience, the GeneXpert system has proven reliable with total concordance with the results obtained with the system already in use in our laboratory. We also observed only a small percentage of invalid results with a satisfactory ratio (1.03) of the number of tests performed to the number producing a result.
    No preview · Article · Sep 2013 · Rivista Italiana della Medicina di Laboratorio
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    ABSTRACT: Background: Blood donors positive only for anti-HBc may have a resolved hepatitis B virus (HBV) infection, low grade chronic infection or infection with variant strains of HBV. We aimed to assess the significance of this serological pattern after hepatitis B vaccination in such cases. Materials and methods: Twenty-four anti-HBc only blood donors were vaccinated with the Engerix HBV vaccine and a serological and virological evaluation was performed before HBV vaccination and 7-10 days after each dose. Subjects were classified as non-responders if their anti-HBs levels stayed below 10 IU/L after full vaccination, while the response was considered secondary (anamnestic) if anti-HBs levels rose over 10 IU/L after the first vaccine dose, and primary if anti-HBs levels rose over 10 IU/L only after the second or third vaccine dose. Results: Of the 21 fully evaluable donors, six had no response, eight showed a primary response and seven had an anamnestic response. One non-responder had transient positivity for HBV-DNA at low levels (12 IU/mL) with persistent negativity for HBsAg. Discussion: Anti-HBc-only positive blood donors are a heterogeneous population including HBV naïve subjects with a likely false-positive anti-HBc reactivity, subjects with a resolved HBV infection, and subjects with persistent low-level HBV replication. The analysis of the anti-HBs response after a dose of HBV vaccine may help to distinguish among the different causes of the isolated anti-HBc positivity, thereby enabling proper counselling and potential readmission to blood donation.
    Full-text · Article · Feb 2013 · Blood transfusion = Trasfusione del sangue
  • S. Valverde · L. Penzo · G. Gessoni
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    ABSTRACT: In this study we evaluated efficiency and quality in our laboratory after the implementation of total laboratory automation for clinical chemistry and immunochemistry assays. Thermo EnGen pre-analytical automation with a track system connecting two Vitros Fusion 5.1 and two Tosoh AIA-2000 analyzers were implemented. For Vitros Fusion 5.1, CVs were <8% (within-run) and <10% (inter-assay), except for measurement of anti-streptolysin O titre (CV 22.7%-27.7%). For Tosoh AIA-2000 analyzers, within-run CVs were <10% and between-run CVs <11%. No drift effects were observed, neither there was any carry-over. When evaluating the functionality of the whole automation system, we observed a turnaround time (TAT) 90% <10 min for tubes needing check-in and exit only. For tubes needing check-in and centrifugation - exit cycle, TAT 90% was <30 min. Result availability for clinical chemistry and/or immunochemistry on-line analyzers showed a TAT 90% <120 min. The adopted automation system effectively reduced the labor associated with specimen processing, possibly decreasing the number of laboratory errors that occur with specimen sorting, labeling and aliquoting, and improved the integrity of specimen handling throughout steps of specimen processing.
    No preview · Article · Feb 2013 · Biochimica clinica
  • G Gessoni · S Valverde · F Manoni
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    ABSTRACT: In this study, we evaluated the GeneXpert HemosIL Factor II and Factor V assay, an innovative assay for the detection of Factor V Leiden (FVL) and prothrombin G20210A mutation (GPRO). We evaluated 132 patients that were previously classified (with a concordant result) using two commercial real-time PCR assays supplied, by Applied Biosystems and Roche Molecular Biochemicals. The cohort comprised 75 normal subjects, 10 FVL homozygous, 35 FVL heterozygous, 7 GPRO heterozygous, 2 GPRO homozygous and 3 double heterozygous FVL and GPRO subjects. All of the samples were evaluated using the GeneXpert HemosIL Factor II and Factor V assay. All of the samples were correctly identified using the GeneXpert HemosIL Factor II and Factor V assay; therefore, in this patient series, the specificity and sensitivity of the test under evaluation was 1.00. We have shown that the GeneXpert HemosIL Factor II and Factor V assay, a rapid fully automated assay, can accurately characterise the presence of FV G1691A and FII G20210A polymorphisms with specificity and sensitivity that are comparable to other current real-time PCR-based methods. The theoretical advantages of such an assay include improved standardisation across varying healthcare environments, more thorough sample manipulation and reduced human error.
    No preview · Article · Apr 2012 · Clinica chimica acta; international journal of clinical chemistry
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    ABSTRACT: In analogy with other areas of laboratory diagnostics, the pre-analytical phase is the leading source of variability also in urinalysis. We carried out a multicentric study for comparing results obtained from first-voided and mid-stream urine samples. Each of the six hospital-based clinical laboratories participating to this study recruited 50 healthy subjects among laboratory staff and/or their relatives. Two consecutive samples of the first morning micturition were collected by vacuum system, the first from the first-void and the second from the mid-stream. Routine urinalysis was performed using dip-stick automated analyzers for chemical examination and automated analyzers for formed particle examination (Sysmex UF-100, Sysmex UF-1000i and Iris iQ-200). Counts of epithelial cells (EC), erythrocytes (ERY) and leukocytes (LEU) but not for cylinders (CAS) were significantly higher in the first-voided samples. A significantly higher count of EC, ERY and LEU was also observed between females and males in first-voided samples, whereas no significant difference could be found in mid-stream samples. Health related analyzer specific upper reference limits (URL) were CAS≤1, EC≤5, ERY≤19, Leu≤13 for UF-100; CAS≤1, EC≤4, ERY≤15, Leu≤11 for UF-1000i; CAS≤1, EC≤4, ERY≤18, Leu≤10 for iQ200. The overall prevalence of subjects with cellular elements count exceeding URL was also higher in first-voided than in mid-stream samples. Mid-stream urine was confirmed as the most appropriate sample, since the presence of contaminating elements, such as bacteria, analytes and formed particles are minimized.
    Full-text · Article · Apr 2012 · Clinical Chemistry and Laboratory Medicine
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    Full-text · Article · Mar 2012 · Blood transfusion = Trasfusione del sangue
  • G. Gessoni · S. Valverde · R. Canistro · F. Marangon · F. Manoni
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    ABSTRACT: Factor V Leiden G1691A mutation (FVL) and prothrombin G20210A mutation (GPro) are the most common inherited mutations associated with thrombophilia. GeneXpert HemosIL Factor II and Factor V assay is a fully automated assay that is able, in less than 35 min, to allow simultaneous detection of FVL and GPro. Test format, based upon single test cartridge, was designed to minimize waste and to permit daily analytical sessions. In this study we evaluated the performance of GeneXpert system in detection of FVL and GPro mutations. 211 consecutive patients, enrolled from March to August 2011, were studied. All samples were evaluated by using the GeneXpert system in comparison with Roche Light Cycler assay. By using both assays, 51 FVL heterozygous, 3 FVL homozygous, 1 GPro homozygous, 10 GPro heterozygous, 5 combined FVL-GPro heterozygous and 141 normal subjects were identified, with a 100% concordance between the two assays. During six months we observed 15 invalid sample results using GeneXpert (7.1%) that were retested after dilution. Consequently, the tests/results ratio was 1.07. In our experience, the assay was therefore affordable and characterized by a good rate between number of carried out tests and released results.
    No preview · Article · Feb 2012 · Biochimica clinica
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    ABSTRACT: Urinary tract infections (UTI) are a common clinical condition. The gold standard for diagnosis is still the bacterial culture, even though a large proportion of evaluated samples are negative. Unnecessary cultures can be reduced by an effective screening test. The aim of this study was to compare two cytometers for rapid diagnosis of UTI. Using 209 urine samples submitted to our laboratory for microbiological examination, we evaluated the analytical performance of the new urine cytometer UF-1000i in comparison with the previous generation analyzer UF-100 (both from Sysmex). We compared bacteria (BACT) and leukocyte (WBC) counts performed by UF-1000i and UF-100 with colony-forming units (CFU) quantification on citrate lactose electrolytes deficient (CLED) agar to assess the best cut-off values. Moreover, a correlation between BACT and WBC quantification performed by the two instruments was carried out. In comparison with 1x10 8 CFU/L, cut-off values of 1.25x10 8 BACT/L and 4x10 7 WBC/L by using UF-1000i, and 3x10 9 BACT/L and 3.5x10 7 WBC/L by using UF-100 were obtained, respectively. While WBC quantification by UF-1000i and UF-100 showed a strong correlation (r=0.98), BACT quantification displayed a poor correlation (r=0.59).
    No preview · Article · Jan 2012 · Biochimica clinica
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    Gianluca Gessoni · Sara Valverde Sara · Rosa Canistro · Fabio Manoni

    Full-text · Article · Dec 2011 · Blood transfusion = Trasfusione del sangue
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    ABSTRACT: These guidelines for the definition of the preanalytical phase of urinalysis were drafted under the auspices of the Italian Society of Laboratory Medicine (SIMeL) and the Italian Society of Clinical Biochemistry and Clinic Molecular Biology (SIBioC). Urinalysis, including both morphological assay and microbiological examination, should always be performed on the basis of an appropriate medical request, and the relative analyses should be selected according to the clinical needs, the patient and the available technology. The reference materials for comprehensive urine examinations should include clear and intelligible recommendations for the preexamination, examination and postexamination procedures. A correct preexamination procedure should include accurate information about the preparation of the patient, and collection, handling, preservation, storage and transport of the specimen. A description of the local skinless and therefore the hierarchical level of urinalysis is also recommended. The chemical/morphological urine examination has undergone some changes over the last few years. As such, it might be the to update and modify accordingly the various activities throughout the total testing process. The advent of new technologies, which have made the laboratory report much more significant as regards the morphological features of this test, has also promoted some reflections about the necessity for further refining and improving the quality of the preexamination process. This can be treated as an opportunity not only to consolidate and standardize the examination process, but also to redefine the clinical objectives by developing a complete, integrated and more clinically meaningful report. These guidelines were elaborated and drafted on the basis of the current literature and the personal experience of the authors. The more significant aspects of these guidelines are the following: Urinalysis should be performed on the basis of a specific clinical need. The sample recommended for urinalysis is the first morning urine collected using a voided midstream technique. Each service of laboratory medicine should make available to the stakeholders printed instructions (with illustrations, whenever possible) concerning the appropriate procedure for collection of specimens. The use of standard devices for urine collection is recommended. The use of an appropriate labelling system is recommended. Urinalysis should be performed as soon as possible after collection. If examination is to be delayed by more than 4 hours, then the samples should be refrigerated. The preparation of adequate protocols for handling, transport and storage of the samples is mandatory. It is necessary to transmit preexamination information from the collection sites to the laboratory that performs the analysis. Deviations from the standard should always be recorded. The hierarchical analytical level available in each laboratory should be declared. We hope that these guidelines concerning the preexamination process of urinalysis have a positive impact on the validation of local working practice, producing a significant improvement in the overall quality of this test (and in the whole field of laboratory medicine as well), so that the results of testing will reflect the real condition of the urinary system of the patient.
    Full-text · Article · Sep 2011 · Rivista Italiana della Medicina di Laboratorio
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    ABSTRACT: A correct approach to the preanalytical phase of chemical, morphological, and microbiological urine examination should include accurate information about the patient preparation, together with recommendations for collection, handling, preservation, storage, and transportation of the specimen. Urinalysis should be performed when a specific clinical need is present. The recommended sample for urinalysis is the first morning urine collected by a voided midstream technique. Each clinical laboratory should make available to its stakeholders printed instructions (including illustrations, whenever possible) concerning the appropriate procedure for urine collection. The use of standard devices for collection and of an appropriate labelling system is recommended. Urinalysis should be performed as soon as possible after collection; if examination is delayed for >4 h, then the samples should be refrigerated. The preparation of adequate protocols for handling, transportation, and storage of samples is mandatory. It is necessary to transmit preanalytical information from sample collection sites to the laboratory performing tests. Description of the local skinless and of hierarchical level of urinalysis is also recommended. Finally, the occurrence of violations from the standard operating rules should always be recorded.
    Full-text · Article · Apr 2011 · Biochimica clinica

Publication Stats

415 Citations
84.71 Total Impact Points

Institutions

  • 2002-2010
    • Civil Hospital, Raikot
      Rāikot, Punjab, India
  • 2007
    • Institute for Transfusion Medicine
      Pittsburgh, Pennsylvania, United States
  • 2003
    • University of Verona
      • Section of Infectious Disease
      Verona, Veneto, Italy
  • 2001
    • University of Padova
      Padua, Veneto, Italy