The role of visiting friends and relatives (VFRS) in imported malaria

With the integration of immigrants in their host countries, a new, special group of travellers - Visiting Friends and Relatives (VFRs) - has emerged over time. The term VFRs refers in particular to immigrants who move to high-income countries from countries where socio-economic status is low, and regularly return to their country of origin, sometimes for fairly long periods of time, to visit their friends and relatives or, where women are concerned, also to give birth and spend the post-partum period with their family. Precisely because they are “special tourists”, VFRs are considered to be at higher risk than other regular travellers of contracting diseases like tuberculosis, HIV and malaria. In fact, because they still feel ethnically integrated in their country of origin, many of them do not take adequate preventive measures to reduce risks to their health.Although many studies have been conducted on this particular group of travellers, we still lack sufficient information, in our country especially, that enables us to undertake suitable prevention initiatives. Malaria is the most frequently contracted infection among VFRs, with a significant difference (p<0.001) compared to more recent immigrants and other categories of travellers. More than 75% of imported malaria cases occur in immigrants, and almost all of them are in the Visiting Friends and Relatives category. In more than 90% of cases the infection is caused by P. falciparum and regards individuals from sub-Saharan African countries. It is important to note that almost all the women and children with imported malaria belong to the VFRs category

New research opportunities for roadside safety barriers improvement

Among the major topics regarding the protection of roads, restraint systems still represent a big opportunity in order to increase safety performances. When accidents happen, in fact, the infrastructure can substantially contribute to the reduction of consequences if its marginal spaces are well designed and/or effective restraint systems are installed there. Nevertheless, basic concepts and technology of road safety barriers have not significantly changed for the last two decades. The paper proposes a new approach to the study aimed to define possible enhancements of restraint safety systems performances, by using new materials and defining innovative design principles. In particular, roadside systems can be developed with regard to vehicle-barrier interaction, vehicle-oriented design (included low-mass and extremely low-mass vehicles), traffic suitability, user protection, working width reduction. In addition, thanks to sensors embedded into the barriers, it is also expected to deal with new challenges related to the guidance of automatic vehicles and I2V communication

Relationship between cervical spine and skeletal class II in subjects with and without temporomandibular disorders

AIM. To assess changes of cranio-cervical structure and of hyoid bone position in skeletal Class II subjects with and without Temporomandibular disorders (TMD). MATERIAL AND METHODS. The cephalometric analysis of 59 subjects with skeletal Class II were evaluated and compared. The measurements considerated were: ANB as parameter of Class II and C0-C1 distance, C1-C2 distance, cranio-cervical angle and hyoid bone position for the cervical spine analysis. Patients were divided into two subgroups: patients with TMD (group A) and patients without TMD (group B). TMD were evaluated with the Diagnostic Criteria for TMD (DC/TMD). Descriptive statistics and Pearson and Spearman correlation analysis, with p-value <0,005, were performed. RESULTS. C0-C1 and C1-C2 distance values and hyoid bone position resulted within normal range in the majority of patients examined. Cranio-cervical angle was alterated in 33 patients. The reduction of this angle with the increase of the ANB value resulted statistically significant in the group A, according to Pearson correlation index. No other data was statistically significant. CONCLUSIONS. Significant relationship between skeletal Class II and cervical spine cannot be highlighted. The alteration of cranio-cervical angle seems to be mildly present, with backward counterclockwise rotation of the head upon the neck in the sample (group A and B). The presence of TMDs as key factor in changes of neck posture could explain the different result between the two groups about relationship between ANB and cranio-cervical angle. This result should be further analyzed in order to better understand if cervical spine changes could be related to mandibular postural ones in the cranio-cervical space or to temporomandibular joints retropositioning, more recognizable in Class II with TMD, which could determine functional changes in other structures of this unit; neck posture also could be the result of a compensatory/ antalgic mechanism in response to TM

The main plant community types of the alpine belt of the Apennine chain

This paper deals with the occurrence of the main plant community types occurring within the alpine bioclimatic belt in the Central Apennines. The study area was represented by three mountain groups, the Gran Sasso, Maiella and Laga mountains. These three mountain chains are those in which, out of the entire Apennine area, alpine vegetation is best expressed. The vegetation has been investigated following the Braun-Blanquet phytosociological approach. During the field work 135 releves were collected. The raw data were further treated with multivariate analysis procedures to find objective clusters on a statistical basis. Several plant community types, belonging to different phytosociological classes, such as Elyno-Seslerietea, Salicetea herbaceae, Thlaspietea rotundifolii, Asplenietea trichomanis, were identified. In particular two new phytosociological associations, Galio-Silenetum acaulis and Potentillo-Festucetum alfredianae, and several new sub-associations are described in this paper. In order to express the occurrence and autonomy of the Apennine alpine bioclimatic belt also in coenological terms, a new Seslerion apenninae sub-alliance, named Leontopodio-Elynenion, is here proposed

Latent Tuberculosis Infection among Healthcare Students and Postgraduates in a Mediterranean Italian Area: What Correlation with Work Exposure?

Background: Tuberculosis screening is part of the standard protocol for evaluating the risk of infection in healthcare workers. The aim of this study was to evaluate the prevalence of latent tuberculosis infection (LTBI) among students attending various healthcare profession degree courses and postgraduate medical courses at the School of Medicine of the University of Palermo, Italy, and assess the possible professional origin of infection. Methods: In total, 2946 students (2082 undergraduates and 864 postgraduates) took part in a screening program for LTBI between January 2014 to April 2019 using the tuberculin skin test (TST). Students with a positive TST result underwent a Quantiferon-TB test (QFT). Results: Among the 2082 undergraduates, 23 (1.1%) had a positiveTST;theresultwasconfirmedwithQFTfor13(0.62%)ofthem. Amongthe864postgraduate students,24(2.78%)hadapositiveTSTandonly18(2.08%)showedapositiveQTF.Latenttuberculosis infectionsweresignificantlymorefrequentamongpostgraduatesthanundergraduates(2.08% &gt; 0.62%, p &lt; 0.0001). There was a higher number of subjects previously vaccinated for TB (18.87% &gt; 0.24%, p &lt; 0.0001), and of vaccinated subjects found positive for TST and QTF (66.67% &gt; 7.69%, p = 0.001) in the postgraduate group. Conclusion: Latent TB is relatively low among medical school students in our geographic area. Nevertheless, this infectious disease must be regarded as a re-emerging biohazard for which preventive strategies are required to limit the risk of infection, especially among exposed workers

Neural correlates of outcome of the psychotherapy compared to antidepressant therapy in anxiety and depression disorders: a meta-analysis

The most prevalent mental disorders, anxiety and depression, are commonly associated with structural and functional changes in the fronto-limbic brain areas. The clinical trials investigating patients with affective disorders showed different outcome to different treatments such as psychotherapy or pharmacotherapy. It is, however, still unexplored how these interventions approach affect the functional brain. This meta-analysis aims to compare the effects of psychotherapy compared to antidepressant therapy on functional brain activity in anxiety and depression disorders. Twenty-one samples with psychotherapy and seventeen samples with antidepressant therapy were included. The main finding showed an inverse effect of the two treatments on the right paracingulate activity. The patients undergoing psychotherapy showed an increase in the right paracingulate activity while pharmacological treatment led to a decrease of activation of this area. This finding seems to support the recent studies that hypothesize how psychotherapy, through the self-knowledge and the meaning processing, involves a top-down emotional regulation

Management of Intra-abdominal Infections due to Carbapenemase-Producing Organisms.

The prevalence of bacterial resistance to carbapenem antibiotics continues to increase because of bacteria producing metallo-β-lactamases (MBL), called carbapenemase-producing organisms (CPO). Enterobacteriaceae, which can be a common cause of intra-abdominal infections (IAIs), have become carbapenem-resistant Enterobacteriaceae (CRE). Updated international guidelines for the treatment of both IAIs and IAIs due to CRE have been published. Given the multifaceted nature of these infections, these recommendations have been jointly reviewed and endorsed by the Surgical Society and the Association of Medical Microbiology and Infectious Disease. The aims of this review are to summarize the general and new generation of multimodal procedure to manage IAIs due to CRE and review the data available on the combination of interventions to reduce CRE. Future research should focus on the development of novel and safe antimicrobial therapies and the quantification of the incremental effect of infection control programmes and new methods to rapidly detect pathogens before patients enter the surgical settin

Candida spp. infections after abdominal urgent surgery: comparative analysis of histologic data for which microbiological results were positive for Candida spp.

EV0515 ePoster Viewing Diagnostic/laboratory methods other than molecular Candida spp. infections after abdominal urgent surgery: comparative analysis of histologic data for which microbiological results were positive for Candida spp. V. Rodolico1, G. Gulotta1, L. Montana1, G. Salamone1, D.C. Paola1 1Department of Sciences for Health Promotion and Mother Child Care, Palermo, Italy Objectives: Microbiological identification is justified when the yeast is isolated from a sterile site, the potential clinical impact of identified isolates from non sterile sites such as intra- abdominal organs don’t help the clinicians to determine whether the strain isolate represents contamination, colonization, or true infection. To investigate the contribute of hystopathological investigations in surgical patients who survive the initial postoperative period we compare histological and microbiological results positive for Candida spp. Methods: A retrospective study of abdominal intraoperative tissue or biopsy specimens obtained from patients admitted for acute abdomen with post-operative microbiological samples positive for Candida spp was performed for the years January 2008 to December 2012. Specimens obtained from autopsy cases were excluded. For each case, demographic data, mortality, comorbidity conditions, antimicrobial therapy, specimen type, the use of special histologic stains, any reported suggestion to correlate with or defer to microbiology, and the individual surgical pathologist were recorded. Results: we evaluated 66 positive candida spp culture reports of which 56 had a concurrent surgical pathology specimen; of the 56 cases 5 were excluded because of a known history of fungal infection, among the remaining we selected 23 (15%) histological results because in these patients clinical, microbiological and enventual other histopathological follow-up data were available. Table 1 showed microbiological and hystopathological data. When other than blood culture specimens such as drainage were positive for candida infection the result was suitable with histological picture. On the other hand, when the blood culture was positive the hystopathological results (proliferative and granulomatous inflammation accompanied by numerous macrophages, lymphocytes, plasma cells and neutrophils) were compatible with the patients’ complications to confirm that Candida spp. is a frequent opportunistic pathogen especially in cancer disease. In table we showed comparative analysis of 23 histologic data for which microbiological results were positive for Candida spp. Microbiological Specimen Positive for Candida spp (n) Concorde Histological features Candida specie Comorbidity Outcome (Died) Blood 6 1 C. albicans=3C. nonalbicans= 3 Cancer=5; Cholecistitis=1 3 (c. albican=2) Bile 4 / C. albicans=1C. non albicans=3 Cancer=2Chronic gastritis plus cholecystitis =2 Drainage 6 6 C. albicans=4C. non albicans=2 Cancer= 4Fistula=2 3 ( c. albicans) Biopsy 4 4 C. albicans=4C. non albicans= Cancer=2Fistula=2 1 (c. non albicans) Urine 1 1 C. albicans Bile plus blood 2 2 C. albicans Conclusions: Post- operative Candida spp infection is an important cause of morbidity and is frequently associated with poor prognosis, particularly in higher risk patients. Complicated intra-abdominal infections diagnosis is mainly a clinical diagnosis, therefore, low expansive supplemental procedures for diagnosis, such as histopathology examination provide insight into the diagnostic significance of Candida spp isolated from surgical specimens other than blood samples

Continuity correction of Pearson’s chi-square test in 2x2 Contingency Tables: A mini-review on recent development

The Pearson’s chi-square test represents a nonparametric test more used in Biomedicine and Social Sciences, but it introduces an error for 2x2 contingency tables, when a discrete probability distribution is approximated with a continuous distribution. The first author to introduce the continuity correction of Pearson’s chi-square test has been Yates F. (1934). Unfortunately, Yates’s correction may tend to overcorrect of p-value, this can implicate an overly conservative result. Therefore many authors have introduced variants Pearson’s chi-square statistic, as alternative continuity correction to Yates’s correction. The goal of this paper is to describe the most recent continuity corrections, proposed for Pearson’s chi-square test