Spotlight on measles 2010: Increased measles transmission in Ferrara, Italy, despite high vaccination coverage, March to May 2010

We report an increase in the incidence of measles in a population with consistently high and improving immunisation coverage in Ferrara province, northern Italy. During the first six months of 2010, 19 cases were confirmed, 10 of which were hospitalised. General practitioners, paediatricians and local healthcare authorities were alerted about the outbreak and asked to notify all suspected cases. We need to further increase immunisation coverage and to maintain and implement the monitoring system

Accuracy of CT-Guided Core-Needle Biopsy in Diagnosis of Thoracic Lesions Suspicious for Primitive Malignancy of the Lung: A Five-Year Retrospective Analysis

Background: Lung cancer represents a heterogeneous group of neoplasms, with the highest frequency and mortality in both sexes combined. In a clinical scenario characterized by the widespread of multidetector-row spiral CT, core-needle biopsy under tomographic guidance is one of the main and safest methods to obtain tissue specimens, even though there are relatively high rates of pneumothorax (0–60% incidence) and pulmonary hemorrhage (4–27% occurrence rates). The aim of this retrospective study is to assess the diagnostic accuracy of CT-guided core-needle biopsy in the diagnosis of primary lung malignancies and to compare our results with evidence from the literature. Materials and Methods: Our analysis included 350 thoracic biopsies, performed from 2017 to 2022 with a 64-row CT guidance and 16/18 G needles mounted on a biopsy gun. We included in the final cohort all samples with evidence of primary lung malignancies, precursor lesions, and atypia, as well as inconclusive and negative diagnoses. Results: There was sensitivity of 90.07% (95% CI 86.05–93.25%), accuracy of 98.87% (95% CI 98.12–99.69%), positive predictive value of 100%, and negative value of 98.74% (95% CI 98.23–99.10%). Specificity settled at 100% (93.84–100%). The AUC was 0.952 (95% CI 0.924–0.972). Only three patients experienced major complications after the procedure. Among minor complications, longer distances from the pleura, the presence of emphysema, and the lower dimensions of the lesions were correlated with the development of pneumothorax after the procedure, while longer distances from the pleura and the lower dimensions of the lesions were correlated with intra-alveolar hemorrhage. Immunohistochemistry analysis was performed in 51% of true positive cases, showing TTF-1, CK7, and p40 expression, respectively, in 26%, 24%, and 10% of analyzed samples. Conclusions: The CT-guided thoracic core-needle biopsy is an extremely accurate and safe diagnostic procedure for the histological diagnosis of lung cancer, a first-level interventional radiology exam for peripheral and subpleural lesions of the lung, which is also able to provide adequate samples for advanced pathologic assays (e.g., FISH, PCR) to assess molecular activity and genetic sequencing

Prevention of fecal-orally transmitted diseases in travelers through an oral anticholeric vaccine (WC/rBS)

Introduction. Estimate the efficacy of oral anticholeric vaccine Dukoral® in subjects travelling to high-risk areas for traveler?s diarrhoea and cholera. Methods. The study involved subjects of both genders who planned to travel to high-risk areas for traveler?s diarrhoea and cholera. Immunization with oral anticholeric vaccine Dukoral® was offered to each one of them. Upon returning, all the participants in the study were asked to complete a self-administered questionnaire consisting of 40 close-ended questions mainly concerning: personal and health data, characteristics (length, destination, reason) of the travel, onset of gastrointestinal symptoms, data relating to the assumption of anti- choleric vaccine and possible adverse reactions. Results. 296 questionnaires have been collected. Mean age was 38.2 years (55.4% males and 44.6% females). Mean travel length was 22.2 days. Reasons for the travel: 66.8% tourism and 33.2% work-cooperation. Most frequent destination was Africa (48.1%), followed by Asia (32.1%) and Central South- America (17.8%). 199 subjects (67.2%) properly executed vac- cination with Dukoral®. The diarrhoea affected 14.1% of vacci- nated subjects and 20.6% of non vaccinated ones. The following cohorts showed statistically significant differences in incidence of diarrhoea: inf. 35 years old age (13.7% vs. 27.1%), travel for work-cooperation (14.1% vs. 35%) and travel length > 28 days (12.1% vs. 40%). No serious adverse events were reported fol- lowing vaccination. Discussion. Oral Anticholeric vaccine proved to be effective and safe in preventing fecal-oral diseases in travelers exposed to high risk conditions

Cerebral hypoperfusion in post-COVID-19 cognitively impaired subjects revealed by arterial spin labeling MRI

Cognitive impairment is one of the most prevalent symptoms of post Severe Acute Respiratory Syndrome COronaVirus 2 (SARS-CoV-2) state, which is known as Long COVID. Advanced neuroimaging techniques may contribute to a better understanding of the pathophysiological brain changes and the underlying mechanisms in post-COVID-19 subjects. We aimed at investigating regional cerebral perfusion alterations in post-COVID-19 subjects who reported a subjective cognitive impairment after a mild SARS-CoV-2 infection, using a non-invasive Arterial Spin Labeling (ASL) MRI technique and analysis. Using MRI-ASL image processing, we investigated the brain perfusion alterations in 24 patients (53.0 ± 14.5 years, 15F/9M) with persistent cognitive complaints in the post COVID-19 period. Voxelwise and region-of-interest analyses were performed to identify statistically significant differences in cerebral blood flow (CBF) maps between post-COVID-19 patients, and age and sex matched healthy controls (54.8 ± 9.1 years, 13F/9M). The results showed a significant hypoperfusion in a widespread cerebral network in the post-COVID-19 group, predominantly affecting the frontal cortex, as well as the parietal and temporal cortex, as identified by a non-parametric permutation testing (p < 0.05, FWE-corrected with TFCE). The hypoperfusion areas identified in the right hemisphere regions were more extensive. These findings support the hypothesis of a large network dysfunction in post-COVID subjects with cognitive complaints. The non-invasive nature of the ASL-MRI method may play an important role in the monitoring and prognosis of post-COVID-19 subjects

Amyotrophic Lateral Sclerosis Multiprotein Biomarkers in Peripheral Blood Mononuclear Cells

Amyotrophic lateral sclerosis (ALS) is a fatal progressive motor neuron disease, for which there are still no diagnostic/prognostic test and therapy. Specific molecular biomarkers are urgently needed to facilitate clinical studies and speed up the development of effective treatments.We used a two-dimensional difference in gel electrophoresis approach to identify in easily accessible clinical samples, peripheral blood mononuclear cells (PBMC), a panel of protein biomarkers that are closely associated with ALS. Validations and a longitudinal study were performed by immunoassays on a selected number of proteins. The same proteins were also measured in PBMC and spinal cord of a G93A SOD1 transgenic rat model. We identified combinations of protein biomarkers that can distinguish, with high discriminatory power, ALS patients from healthy controls (98%), and from patients with neurological disorders that may resemble ALS (91%), between two levels of disease severity (90%), and a number of translational biomarkers, that link responses between human and animal model. We demonstrated that TDP-43, cyclophilin A and ERp57 associate with disease progression in a longitudinal study. Moreover, the protein profile changes detected in peripheral blood mononuclear cells of ALS patients are suggestive of possible intracellular pathogenic mechanisms such as endoplasmic reticulum stress, nitrative stress, disturbances in redox regulation and RNA processing.Our results indicate that PBMC multiprotein biomarkers could contribute to determine amyotrophic lateral sclerosis diagnosis, differential diagnosis, disease severity and progression, and may help to elucidate pathogenic mechanisms

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Un nouveau rôle pour Hélios au cours du développement et du vieillissement des cellules souches hématopoïétiques

Hematopoietic Stem and Progenitor Cells (HSPC) engender all the mature blood cells throughout life. They are subdivided in undifferentiated stem cells (HSC) and primed multipotent progenitors (MPP). MPP are heterogeneous and composed of erythro-megakaryocytes (MMP2), myeloid (MPP3) and lymphoid (MPP4) primed cells. Despite the fact that these populations are well defined, the molecular mechanisms underlying their differentiation remain unclear. We showed that the transcription factor Helios, highly expressed in the HSPC, is crucial for HSPC specification and aging. Bone marrow transplantation, ex-vivo differentiation and flow cytometry assays revealed that Helios deficient mice have reduced MPP4 as well as lymphoid progenitors. This deficiency is offset by an increase in MPP3, granulo-monocyte and megakaryocyte progenitors. Moreover,transcriptional analysis of HSPC revealed that Helios deficiency affects mainly HSC with an enrichment of megakaryocyte and old HSC genes signatures, where as Helios deficient MPP express lower levels of lymphoid specific genes. Our work reveals Helios as a novel regulator of HSC specification and aging.Les cellules souches et progénitrices hématopoïétiques (CSPH) produisent les cellules sanguines durant toute la vie. Elles sont divisées en cellules souches indifférenciées (CSH) et en cellules progénitrices multipotentes engagées (MPP). Les MPP sont hétérogènes et composées de cellules progénitrices multipotentes engagées vers les lignages érythro-mégacaryocytaires (MPP2), myéloïdes (MPP3) et lymphoïdes (MPP4). Malgré que ces populations cellulaires soient bien définies, les mécanismes moléculaires gouvernants leurs différenciations restent en grande partie encore inconnus. Nous avons montré que le facteur de transcription Hélios, exprimé fortement dans les CSPH, est crucial pour la spécification et le vieillissement des CSPH. Les greffes de moëlle osseuse et les expériences de différenciation ex-vivo et de cytométrie en flux montrent que les souris déficientes pour Hélios possèdent un nombre réduit de MPP4 et de progéniteurs lymphoïdes. Ce déficit est compensé par une augmentation du nombre de MPP3 et de progéniteurs granulo-monocytaires et mégacaryocytaires. De plus l’analyse transcriptionnelle des CSPH indique que la déficience pour Hélios affecte principalement les CSH exprimant des gènes spécifiques aux mégacaryocytes et aux vieilles CSH, tandis que les MPP déficients pour Hélios expriment faiblement les gènes spécifiques aux cellules lymphoïdes. Notre travail montre que Hélios est un nouveau régulateur de la spécification et du vieillissement des HSC