61 research outputs found

    Risk factors for acquisition of hepatitis C virus infection: a case series and potential implications for disease surveillance

    Get PDF
    BACKGROUND: Transmission of hepatitis C vims (HCV) is strongly associated with use of contaminated blood products and injection drugs. Other "non-parental" modes of transmission including sexual activity have been increasingly recognized. We examined risk factors for acquiring HCV in patients who were referred to two tertiary care centers and enrolled in an antiviral therapy protocol. METHODS: Interviews of 148 patients were conducted apart from their physician evaluation using a structured questionnaire covering demographics and risk factors for HCV acquisition. RESULTS: Risk factors (blood products, injection/intranasal drugs, razor blades/ toothbrushes, body/ear piercing, occupational exposure, sexual activity) were identified in 141 (95.3%) of participants; 23 (15.5%) had one (most frequently blood or drug exposure), 41 (27.7%) had two, and 84 (53.4%) had more than two risk factors. No patient reported sexual activity as a sole risk factor. Body piercing accounted for a high number of exposures in women. Men were more likely to have exposure to street drugs but less exposure to blood products than women. Blood product exposure was less common in younger than older HCV patients. CONCLUSION: One and often multiple risk factors could be identified in nearly all HCV-infected patients seen in a referral practice. None named sexual transmission as the sole risk factor. The development of a more complete profile of factors contributing to transmission of HCV infection may assist in clinical and preventive efforts. The recognition of the potential presence of multiple risk factors may have important implications in the approach to HCV surveillance, and particularly the use of hierarchical algorithms in the study of risk factors

    Comparative genomic analysis of toxin-negative strains of Clostridium difficile from humans and animals with symptoms of gastrointestinal disease

    Get PDF
    Background: Clostridium difficile infections (CDI) are a significant health problem to humans and food animals. Clostridial toxins ToxA and ToxB encoded by genes tcdA and tcdB are located on a pathogenicity locus known as the PaLoc and are the major virulence factors of C. difficile. While toxin-negative strains of C. difficile are often isolated from faeces of animals and patients suffering from CDI, they are not considered to play a role in disease. Toxin-negative strains of C. difficile have been used successfully to treat recurring CDI but their propensity to acquire the PaLoc via lateral gene transfer and express clinically relevant levels of toxins has reinforced the need to characterise them genetically. In addition, further studies that examine the pathogenic potential of toxin-negative strains of C. difficile and the frequency by which toxin-negative strains may acquire the PaLoc are needed. Results: We undertook a comparative genomic analysis of five Australian toxin-negative isolates of C. difficile that lack tcdA, tcdB and both binary toxin genes cdtA and cdtB that were recovered from humans and farm animals with symptoms of gastrointestinal disease. Our analyses show that the five C. difficile isolates cluster closely with virulent toxigenic strains of C. difficile belonging to the same sequence type (ST) and have virulence gene profiles akin to those in toxigenic strains. Furthermore, phage acquisition appears to have played a key role in the evolution of C. difficile. Conclusions: Our results are consistent with the C. difficile global population structure comprising six clades each containing both toxin-positive and toxin-negative strains. Our data also suggests that toxin-negative strains of C. difficile encode a repertoire of putative virulence factors that are similar to those found in toxigenic strains of C. difficile, raising the possibility that acquisition of PaLoc by toxin-negative strains poses a threat to human health. Studies in appropriate animal models are needed to examine the pathogenic potential of toxin-negative strains of C. difficile and to determine the frequency by which toxin-negative strains may acquire the PaLoc

    Anticipating the Unpredictable: A Review of Antimicrobial Stewardship and Acinetobacter Infections

    Full text link

    Inheritance of deleterious mutations at both BRCA1 and BRCA2 in an international sample of 32,295 women

    Full text link

    CYMBELINE: UN ROMANCE STORICO

    No full text
    Abstract: Il comico in Cymbeline, come negli altri romances, consiste in un superamento dell’entropia della precedente scrittura tragica, soprattutto di King Lear. Come in Lear, nell’incipit la figlia Imogen viene allontanata e si allontana da un padre appassionatamente furioso. Mentre nella tragedia Cor- delia è vittima del “darker purpose”, della cieca pulsione paterna che blocca la successione generazionale, in Cymbeline la figlia è strumento del fertile passaggio da una generazione all’altra. Nel romance la pace riparativa tra padre e figlia avverrà attraverso le tribolazioni della giovane coppia (Imo- gen e Posthumus) in due Rome di età diverse, ma collegate per antitesi. I due setting, infatti, se permettono a Shakespeare di criminalizzare la Roma papista italianata, corrotta e sessuofobica, gli consentiranno, invece, la rap- presentazione di una Roma augustea che permette la pace e dunque la trans- latio imperii da Roma alla Britannia di Cymbeline, benedetta dall’azione risanatrice di una nuova donna, Imogen: una ‘romantica’ reinvenzione sto- rica
    corecore