Primary hepatitis A vaccination failure is a rare although possible event: results of a retrospective study

A case of Hepatitis A occurred in a traveller in spite of a complete course of immunization with a combined HAV and HBV vaccine [Taliani G, Sbaragli S, Bartoloni A, Santini MG, Tozzi A, Paradisi F Hepatitis A vaccine failure: how to treat the threat. Vaccine 2003;21(31):4505-6]. A retrospective study was per-formed to evaluate whether the failure was primary or could be attributed to a specific lot of vaccine or to its inadequate handling and/or storage. Two distinct populations of vaccinees were selected in a 1:2 proportion. The case group (N=31) included subjects who were vaccinated in the same period and with the same lot and batch of vaccine as the case. The control group (N=62) included subjects who received different lot and batch of the same vaccine as the case group. A persisting antibody response to HAV vaccine was found among all subjects (anti-HAV > 20 mIU/ml). The overall anti-HBs seropositivity rate (anti-HBs > 10 mIU/ml) was 74%, without significant difference between the case (77%) and the control group (73%; P > 0.05). The reported Hepatitis A case can be attributed to a rare primary vaccine failure rather than to inefficacy of a specific lot of vaccine or to inappropriate vaccine handling or storage. Our study supports the indications for use of combined Hepatitis A+B immunization in travellers at risk for both infections, but stresses the need for information on correct hygienic behaviours while abroad. (c) 2006 Elsevier Ltd. All rights reserved

High prevalence of clustered tuberculosis cases in peruvian migrants in Florence, Italy.

Tuberculosis is a leading cause of morbidity for Peruvian migrants in Florence, Italy, where they account for about 20% of yearly diagnosed cases. A retrospective study on cases notified in Peruvian residents in Florence in the period 2001-2010 was carried out and available Mycobacterium tuberculosis strains were genotyped (MIRU-VNTR-24 and Spoligotyping). One hundred thirty eight cases were retrieved. Genotyping performed in 87 strains revealed that 39 (44.8%) belonged to 12 clusters. Assuming that in each cluster the transmission of tuberculosis from the index case took place in Florence, a large proportion of cases could be preventable by improving early diagnosis of contagious cases and contact tracing

KRAS mutation in lung metastases from colorectal cancer : Prognostic implications

KRAS mutant colorectal cancer (CRC) patients develop lung and brain metastases more frequently than KRAS wild-type (WT) counterpart. We retrospectively investigated the prognostic role of KRAS, BRAF, and PIK3CA (exon 20) mutations and loss of phosphatase and tensin homolog (PTEN) in surgically resected lung metastases. Lung specimens from 75 metastatic CRC (mCRC) patients treated with one or more metastasectomies with curative intent were analyzed. Sixty-four percent of patients had KRAS WT lung metastases. PTEN loss-of-function was found in 75%. BRAF and PIK3CA exon 20 mutations were not found. Seven patients subsequently developed brain metastases and 43% of them had KRAS mutation. In univariate analysis, median overall survival (OS) for KRAS WT patients was longer, compared to KRAS mutant patients (median 60.9 vs. 36.6\ua0months, P\ua0=\ua00.035). In addition, both progression-free survival (PFS) and lung disease-free survival (LDFS) between lung surgery and relapse were not associated with KRAS and PTEN status. In multivariate analysis, the risk of death was significantly increased by KRAS mutational status (OS Hazard ratio (HR) 2.17, 95% IC 1.19-3.96, P\ua0=\ua00.012) and lack of adjuvant chemotherapy (OS HR 0.10, 95% IC 0.01-0.74, P\ua0=\ua00.024). The proportion of KRAS mutations in lung metastases was similar to the expected proportion in primary tumors. Patients harboring KRAS mutation had a poorer survival rate compared to WT group both in univariate and multivariate analysis. Moreover, administration of adjuvant chemotherapy after lung metastasectomy (LM) significantly improved both PFS and OS. KRAS mutation is a negative prognostic factor in mCRC patients undergoing LM. Further larger and prospective studies are necessary to confirm these findings

Le linee del mare

Il contributo illustra il progetto presentato al concorso internazionale di idee per la riqualificazione del Lungomare di RomaThe paper illustrates the project presented to the international ideas competition for the redevelopment of the seafront of Rom

Concorso Internazionale di idee: la Riqualificazione del lungomare di Latina

il progetto ha ricevuto la menzione special