Risk factors for intussusception in childhood gastroenteritis: a nationwide cross-sectional study in Italy

Background. The aetiology of intussusception is unknown for most of the cases studied, although some associated conditions have been identified. We aimed to clarify the role played by enteric pathogens as potential risk factors for intussusception.   Methods. A retrospective review of the records relating to hospitalizations for gastroenteritis with or without concurrent intussusception in Italian children was conducted among children aged <6 years old during the period 2005-2012. Through a multivariate logistic regression model, the associations, expressed as odds ratios with 95% confidence intervals, were estimated between the presence of gastroenteritis with intussusception and the explanatory variables, such as sex, age, the aetiology of gastroenteritis and whether the subjects lived in the North, South and Islands or Centre Italy. Results. A total of 174 records related to admissions due to the concomitant manifestation of gastroenteritis and intussusception were extracted and analyzed. The estimate of the adjusted odds ratio confirmed the significant contribution that sex and geographical location made to hospitalizations both for gastroenteritis with concurrent intussusception, and in the associated secondary diagnosis of gastroenteritis, with the exception of the rotavirus, where a different seasonality and a bucking trend were observed. The probability of intussusception became statistically significant lower from 12 months of age to ≤23 months and for age 48-59 months, respect to the first year of life. Conclusions. Our observational study highlighted males, affected by enteric infections, other than rotavirus and parasitic, living in North and Centre of Italy have an increased risk of developing intussusceptions. In the second and fifth year of life the probability of intussusceptions becomes lower than in the first year. Additional research is needed to confirm these findings and evaluate the pathogenesis which may link such infections with intussusception.&nbsp

Squamous Cell Carcinoma of the Eyelid with Ocular Metastases in a Domestic Cat

Background: Eye neoplasms are infrequent in felines and usually affect the eyelids. Squamous cell carcinoma (SCC) is a neoplasm that occurs owing to recurrent lesions caused by solar radiation and affects the margins of the ears, eyelids, nose and lips of animals with light-colored coat. The clinical signs consist of ulcerated, crusty lesions that may form masses. The diagnosis is established by means of histopathological analysis, and the prognosis depends on the area affected and tumor infiltration. This work aimed to describe a case of SCC in the eyelid with invasion of the eye and its adnexa in a cat, highlighting clinical aspects and the importance of the anatomopathological examination. Case: A female mixed breed senile cat that had been rescued from the streets was brought in for examination. Dehydration and a low body condition score were observed at the general clinical examination. A physical inspection revealed the presence of an ulcerated periocular lesion on the eyelid; the right eye exhibited increased size and loss of definition of its internal structures. The presence of malodorous cerumen in the right ear canal, a tilted head, and walking in circles to the right were also noted. A dysplastic epithelium along with neutrophilic inflammation was observed at the cytopathological analysis. The treatment instituted consisted of administration of antibacterial and anti-inflammatory drugs, and cleaning of the ear. On the follow-up appointment, 2 days later, the patient’s condition had worsened and in spite of the supportive therapy administered, the animal died. An anatomopathological study of the body identified, in addition to the alterations in the eyelid and the eye mentioned above, a traumatic lesion with perforation of the mandibular bone, and presence of a brownish content with caseous consistency in the right ear canal. After visualization of the microscopic alterations, the diagnosis established was squamous cell carcinoma of the eyelid with metastases in the optical nerve and choroid blood vessels. Discussion: Squamous cell carcinoma is one of the most common epithelial neoplasms in felines, and can occur in any region of the face; however, the eyelids and the eyes are less frequently affected, which confirms that the case reported here is uncommon. SCC has a higher incidence in female cats older than 10 years of age with light-colored coat and highly exposed to ultraviolet radiation. The case reported here exhibited these characteristics, as the patient had been rescued from the streets where exposition to sunlight is intense. The clinical presentation was consistent with that described in other works, with ulcerated crusty lesions on the eyelid and the nose. Vestibular syndrome, as inferred from the tilted head and circular gait (walking in circles to the right), could be explained by internal otitis, which was observed at necropsy. The cytological analysis of the eye lesion demonstrated the presence of a neutrophilic inflammatory process along with a dysplastic or immature squamous epithelium, which prompted for therapy using antimicrobial and anti-inflammatory drugs. The definitive diagnosis was established with basis on the histopathological analysis, which revealed a pattern of neoplastic cells arranged in clusters or strands connected to the epidermal surface, and the presence of “keratin pearls” consistent with SCC affecting not only the eyelid and the eye, but also invading the optical nerve and the choroid blood vessels. The prognosis was unfavorable owing to the advanced stage of the tumor and concomitant diseases. Even though the development of SCC in the eyelid is relatively common, the occurrence of metastasis in the eye adnexa is rare in felines. An anatomopathological study was required to establish the diagnosis of SCC as the patient’s clinical history data were scarce. Keywords: squamous cell carcinoma, feline, eye neoplasm, oncology. Título: Carcionoma de células escamosas em pálpebra com metástase ocular em um gato doméstico. Descritores: carcinoma de células escamosas, felino, neoplasia ocular, oncologia

Efficacy and Tolerability of a New Formulation in Rectal Ointment Based on Zn-L-Carnosine (Proctilor®) in the Treatment of Haemorrhoidal Disease

Haemorrhoidal disease (HD) shows high prevalence in western countries, reaching 4.4% per year in the US. Topical preparations are the first-line treatments, which are readily available as "over-the-counter" (OTC) products, often containing a nonstandardised mixture of "natural" remedies, or anaesthetics or cortisol;those latter are not free from undesirable effects. The Zinc-L-Carnosine is a cytoprotective compound, promoting mucosal repair in the gastrointestinal tract and also in mucosal repair, following radiation injuries to the rectum as well as in ulcerative colitis. Our aim was to study the efficacy of Zinc-L-Carnosine in relieving acute symptoms of HD, testing a preparation in the rectal ointment, Proctilor (R), in patients complaining of bleeding or thrombosed piles. In a multicentre open trial, 21 patients older than 18 years of age were enrolled. The symptoms of HD were graded according to the Haemorrhoidal Disease Symptoms Score (HDSS) in association with the Short Health Scale (SHS) to assess the influence of HD on quality of life. The pain was assessed with the VAS score, bowel habit by means of the Bristol scale. The patients were evaluated at enrolment (T0) and 2 (T1) and 4 (T2) weeks of treatment with Proctilor (R) rectal ointment. There were 10 men and 11 women; mean age, 49 years. Pain, bleeding, and thrombosis were all significantly reduced after treatment; the mean VAS score decreased from 4.71 +/- 3.05 at T0 to.52 +/- 0.87 and.05 +/- 0.22 at T1 and T2, respectively; (mean +/- SD; p < 0.001 in both cases). Similarly, the HDSS score showed to be significantly reduced between T0, T1 (8.05 +/- 4.55 vs. 1.14 +/- 1.01), and T2 (8.05 +/- 4.55 vs. 24 +/- 0.44) (mean +/- SD; p < 0.001 in both cases). Quality of life showed to be improved as the SHS score decreased significantly with treatment (7.90 +/- 4.17 at T0 vs. 4.24 +/- 0.44 at T1 vs. 4.05 +/- 0.22 at T2; mean +/- SD; p < 0.001 in both cases). The Bristol score of defecation remained substantially unchanged. No side effects or discontinuation of treatment were reported. Results of our investigation suggest a role of Proctilor (R) rectal ointment in treating symptomatic HD with good results and an excellent safety profile. However, our preliminary results encourage further studies on a larger number of patients to confirm the role of Zinc-L-Carnosine in the rectal ointment for the topical treatment of HD

Remissão diabética de um felino sem raça definida: Relato de caso

O Diabetes Melitus (DM) é uma síndrome que se caracteriza pela hiperglicemia persistente decorrente da falta de insulina ou da incapacidade de exercer seus efeitos metabólicos. Junto com o hipertireoidismo, é uma das doenças endócrinas mais comuns em felinos, sendo que os gatos obesos têm 3.9 vezes mais chance de desenvolver DM do que um gato em escore de condição corporal ideal. No presente relato, o caso descrito é de uma gata de cinco anos de idade, castrada, sem raça definida, com histórico de obesidade (escore de condição corporal prévio 8/9), apresentando perda de peso e polifagia. O histórico de obesidade prévia associado às manifestações clínicas sugeriram a possibilidade de DM, confirmado diante da hiperglicemia, glicosúria e elevação dos valores séricos de frutosamina. Foi instituído terapia com insulina glargina, dieta coadjuvante para obesidade e enriquecimento ambiental, ocorrendo remissão do DM

Well-Being and Perceived Quality of Life in Elderly People Displaced After the Earthquake in L’Aquila, Italy

On 6 April 2009, the city of L’Aquila was hit by a violent earthquake that destroyed almost all of its medieval centre, and the surviving inhabitants were evacuated and relocated in temporary quarters or undamaged homes. The aim of this study was to investigate the perceived quality of life of the elderly population 3 years after the earthquake in relation to the social and logistic issues of new housing. The study was carried out between October 2011 and March 2012, and involved 571 subjects aged over 65 years living in the municipality of L’Aquila. The interviews took place in the surgeries of general practitioners and the city’s Department of Prevention and Vaccination in the anti-influenza immunisation period. The instrument used was a 36-item questionnaire with closed, multiple choice answers divided into the following sections: demographics, everyday activities, health and perceived health, and the quality of life in the city. The results show that, 3 years after the earthquake, the elderly population living in the new towns and temporary housing of L’Aquila have a worse perception of their quality of life than the others. They feel a certain social isolation and wish to live elsewhere. Governments faced with the problems arising from a natural calamity should take into account all of the elements making up a good quality of life and, before making choices whose impact cannot be changed, consider both their immediate and long-term social consequences

Enhancement of radiosensitivity by the novel anticancer quinolone derivative vosaroxin in preclinical glioblastoma models

Purpose: Glioblastoma multiforme (GBM) is the most aggressive brain tumor. The activity of vosaroxin, a first-in-class anticancer quinolone derivative that intercalates DNA and inhibits topoisomerase II, was investigated in GBM preclinical models as a single agent and combined with radiotherapy (RT). Results: Vosaroxin showed antitumor activity in clonogenic survival assays, with IC50 of 10-100 nM, and demonstrated radiosensitization. Combined treatments exhibited significantly higher γH2Ax levels compared with controls. In xenograft models, vosaroxin reduced tumor growth and showed enhanced activity with RT; vosaroxin/RT combined was more effective than temozolomide/RT. Vosaroxin/ RT triggered rapid and massive cell death with characteristics of necrosis. A minor proportion of treated cells underwent caspase-dependent apoptosis, in agreement with in vitro results. Vosaroxin/RT inhibited RT-induced autophagy, increasing necrosis. This was associated with increased recruitment of granulocytes, monocytes, and undifferentiated bone marrow-derived lymphoid cells. Pharmacokinetic analyses revealed adequate blood-brain penetration of vosaroxin. Vosaroxin/RT increased disease-free survival (DFS) and overall survival (OS) significantly compared with RT, vosaroxin alone, temozolomide, and temozolomide/RT in the U251-luciferase orthotopic model. Materials and Methods: Cellular, molecular, and antiproliferative effects of vosaroxin alone or combined with RT were evaluated in 13 GBM cell lines. Tumor growth delay was determined in U87MG, U251, and T98G xenograft mouse models. (DFS) and (OS) were assessed in orthotopic intrabrain models using luciferasetransfected U251 cells by bioluminescence and magnetic resonance imaging. Conclusions: Vosaroxin demonstrated significant activity in vitro and in vivo in GBM models, and showed additive/synergistic activity when combined with RT in O6- methylguanine methyltransferase-negative and -positive cell lines

Trogocytosis in innate immunity to cancer is an intimate relationship with unexpected outcomes

Trogocytosis is a cellular process whereby a cell acquires a membrane fragment from a donor cell in a contact-dependent manner allowing for the transfer of surface proteins with functional integrity. It is involved in various biological processes, including cell-cell communication, immune regulation, and response to pathogens and cancer cells, with poorly defined molecular mechanisms. With the exception of eosinophils, trogocytosis has been reported in most immune cells and plays diverse roles in the modulation of anti-tumor immune responses. Here, we report that eosinophils acquire membrane fragments from tumor cells early after contact through the CD11b/CD18 integrin complex. We discuss the impact of trogocytosis in innate immune cells on cancer progression in the context of the evidence that eosinophils can engage in trogocytosis with tumor cells. We also discuss shared and cell-specific mechanisms underlying this process based on in silico modeling and provide a hypothetical molecular model for the stabilization of the immunological synapse operating in granulocytes and possibly other innate immune cells that enables trogocytosis

Seroprevalence of Ebola virus infection in Bombali District, Sierra Leone

A serosurvey of anti-Ebola Zaire virus nucleoprotein IgG prevalence was carried out among Ebola virus disease survivors and their Community Contacts in Bombali District, Sierra Leone. Our data suggest that the specie of Ebola virus (Zaire) responsible of the 2013-2016 epidemic in West Africa may cause mild or asymptomatic infection in a proportion of cases, possibly due to an efficient immune response

Measles-Related Hospitalizations in Italy, 2004–2016: The Importance of High Vaccination Coverage

Background: Measles is a highly contagious human infectious disease. It can lead to serious complications and often requires hospitalization. In Italy, as in other European countries, the goal of measles elimination in 2015 failed. To reach this target, identifying susceptible individuals, closing any immunity gaps and reaching adequate vaccination coverage is necessary. Objective: To contribute to these purposes, a retrospective observational study on measles-related hospitalization between 2004 and 2016 in Italy was conducted, using the national hospital discharge database as informational flow. Methods: Admission frequencies and hospitalization rates were compared between regions with low (90% led to a halving of measles hospitalizations, but it is insufficient for the elimination: ≥95% coverage continues to be the target to be reached

Active surveillance of adverse events after immunization (AEFI) from the Local Health Unit of Ferrara, Italy

IntroductionVaccine vigilance implies the collection, evaluation, analysis and communication of adverse events following immunization (AEFI) and is a useful tool for vaccine monitoring allowing, even after approval and marketing, to check its safety/tolerability. The multiregional project "Active surveillance of adverse vaccine reactions", joined by the AUSL of Ferrara, is aimed at making parents of children, who have undergone at least one vaccination provided by the regional vaccination calendar in the first 24 months of life, aware of the reporting of any AEFI via mobile phone-SMS.MethodsAn analysis of the project data, collected in the period March 2018 - May 2019, was carried out, to evaluate the effectiveness of the reporting tool and the type and frequency of AEFI. Anonymized data were analyzed by number, gender, distribution by age, type of vaccine, adverse event, severity and outcome.ResultsA total of 1494 consents and 983 SMS messages were obtained from parents.The vaccine doses carried out were 1,984 (28.3% hexavalent, 28% PCV13, 17% anti-rotavirus, 14.3% Men-B). Almost all (99.5%) AEFI were classified as "not serious".Based on the Organ System Class (SOC), most reports are related to "General Disorders and Administration Site Conditions" (52.3%), followed by "Psychiatric Disorders" (26.5%) and "Metabolic and nutrition disorders" (12.5%).ConclusionsThe reported AEFI are in line with the ones reported in the literature.Reporting via SMS is a valid vaccine surveillance tool contributing to the qualitative and quantitative improvement of the information transmitted