Detection of Extended- Spectrum Beta-Lactamase producing Escherichia coli from mesenteric lymph nodes of wild boars (Sus scrofa)

Wild boars (Sus scrofa) are increasing in several European countries, including Italy. In areas with intensive animal farming, like the Italian Emilia-Romagna region, they are likely to be exposed to antimicrobialresistant (AMR) bacteria of livestock origin. In 2017-2018, 108 mesenteric lymph nodes samples were collected from 108 wild boars hunted in Parma province, Emilia-Romagna region, to be tested for ESBL- and carbapenemase-producing Escherichia coli. One isolate (WB-21L) out of 108 (0.9%) was phenotypically confirmed as ESBLproducing E. coli. The strain WB-21L was tested by PCR for the genes blaSHV, blaCTX-M, blaTEM, blaAmpC, blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48, blaSPM, blaBIC, blaSIM, blaDIM, blaGIM, blaAIM, resulting positive for TEM β-lactamase. Resistance to ampicillin, amoxicillin/clavulanic acid, streptomycin, sulfasomidine, tetracycline and trimethoprim confirmed the multi-resistance nature of the strain WB-21L. Nine E. coli isolates showed resistance to meropenem by the Kirby Bauer test but none of them showed Meropenem MIC values indicative of resistance. In conclusion, the present study shows the presence of ESBL E. coli in wild boars and the possible risk of transfer to game meat handlers and consumers. Future studies are needed to better evaluate the sources of AMR bacteria in wildlife

Contrasting styles of (U)HP rock exhumation along the Cenozoic Adria-Europe plate boundary (Western Alps, Calabria, Corsica)

Since the first discovery of ultrahigh pressure (UHP) rocks 30 years ago in the Western Alps, the mechanisms for exhumation of (U)HP terranes worldwide are still debated. In the western Mediterranean, the presently accepted model of synconvergent exhumation (e.g., the channel-flow model) is in conflict with parts of the geologic record. We synthesize regional geologic data and present alternative exhumation mechanisms that consider the role of divergence within subduction zones. These mechanisms, i.e., (i) the motion of the upper plate away from the trench and (ii) the rollback of the lower plate, are discussed in detail with particular reference to the Cenozoic Adria-Europe plate boundary, and along three different transects (Western Alps, Calabria-Sardinia, and Corsica-Northern Apennines). In the Western Alps, (U)HP rocks were exhumed from the greatest depth at the rear of the accretionary wedge during motion of the upper plate away from the trench. Exhumation was extremely fast, and associated with very low geothermal gradients. In Calabria, HP rocks were exhumed from shallower depths and at lower rates during rollback of the Adriatic plate, with repeated exhumation pulses progressively younging toward the foreland. Both mechanisms were active to create boundary divergence along the Corsica-Northern Apennines transect, where European southeastward subduction was progressively replaced along strike by Adriatic northwestward subduction. The tectonic scenario depicted for the Western Alps trench during Eocene exhumation of (U)HP rocks correlates well with present-day eastern Papua New Guinea, which is presented as a modern analog of the Paleogene Adria-Europe plate boundary

Natural History and Outcome of Hepatic Vascular Malformations in a Large Cohort of Patients with Hereditary Hemorrhagic Teleangiectasia

BACKGROUND: Hereditary hemorrhagic telangiectasia is a genetic disease characterized by teleangiectasias involving virtually every organ. There are limited data in the literature regarding the natural history of liver vascular malformations in hemorrhagic telangiectasia and their associated morbidity and mortality. AIM: This prospective cohort study sought to assess the outcome of liver involvement in hereditary hemorrhagic telangiectasia patients. METHODS: We analyzed 16 years of surveillance data from a tertiary hereditary hemorrhagic telangiectasia referral center in Italy. We considered for inclusion in this study 502 consecutive Italian patients at risk of hereditary hemorrhagic telangiectasia who presented at the hereditary hemorrhagic telangiectasia referral center and underwent a multidisciplinary screening protocol for the diagnosis of hereditary hemorrhagic telangiectasia. Of the 502 individuals assessed in the center, 154 had hepatic vascular malformations and were the subject of the study; 198 patients with hereditary hemorrhagic telangiectasia and without hepatic vascular malformations were the controls. Additionally, we report the response to treatment of patients with complicated hepatic vascular malformations. RESULTS: The 154 patients were included and followed for a median period of 44 months (range 12-181); of these, eight (5.2%) died from VM-related complications and 39 (25.3%) experienced complications. The average incidence rates of death and complications were 1.1 and 3.6 per 100 person-years, respectively. The median overall survival and event-free survival after diagnosis were 175 and 90 months, respectively. The rate of complete response to therapy was 63%. CONCLUSIONS: This study shows that substantial morbidity and mortality are associated with liver vascular malformations in hereditary hemorrhagic telangiectasia patients

Wearable devices for gait and posture monitoring via telemedicine in people with movement disorders and multiple sclerosis: a systematic review

Introduction: Wearable devices and telemedicine are increasingly used to track health-related parameters across patient populations. Since gait and postural control deficits contribute to mobility deficits in persons with movement disorders and multiple sclerosis, we thought it interesting to evaluate devices in telemedicine for gait and posture monitoring in such patients. Methods: For this systematic review, we searched the electronic databases MEDLINE (PubMed), SCOPUS, Cochrane Library, and SPORTDiscus. Of the 452 records retrieved, 12 met the inclusion/exclusion criteria. Data about (1) study characteristics and clinical aspects, (2) technical, and (3) telemonitoring and teleconsulting were retrieved, The studies were quality assessed. Results: All studies involved patients with Parkinson's disease; most used triaxial accelerometers for general assessment (n = 4), assessment of motor fluctuation (n = 3), falls (n = 2), and turning (n = 3). Sensor placement and count varied widely across studies. Nine used lab-validated algorithms for data analysis. Only one discussed synchronous patient feedback and asynchronous teleconsultation. Conclusions: Wearable devices enable real-world patient monitoring and suggest biomarkers for symptoms and behaviors related to underlying gait disorders. thus enriching clinical assessment and personalized treatment plans. As digital healthcare evolves, further research is needed to enhance device accuracy, assess user acceptability, and integrate these tools into telemedicine infrastructure

Note illustrative della Carta Geologica d’Italia alla scala 1: 50.000: Foglio 128 Venezia

Published6A. Monitoraggio ambientale, sicurezza e territorioope

Hallazgos imagenológicos típicos y atípicos del síndrome de leucoencefalopatía posterior reversible Typical and atypical imaging findings of Posterior Reversible Leukoencephalopathy syndrome

Propósito: Realizar una revisión del síndrome de leucoencefalopatía posterior reversible, destacando los hallazgos imagenológicos atípicos del mismo. Materiales y métodos: Se estudiaron retrospectivamente 10 casos (n=10), 6 mujeres y 4 varones con edades comprendidas entre 7 y 84 años (media 40.6 años), con un tomógrafo multicorte (Siemens Sensation 16, Erlangen, Germany) y dos resonadores (Magnetom Symphony 1.5T y Magnetom Impact 1T) entre octubre del año 2000 y mayo del 2007. Resultados: En nuestra casuística, el 40% (n=4) de los pacientes presentó edema citotóxico (hiperintensidad en Difusión); el 70% (n=7), compromiso del circuito anterior; el 20% (n=2) presentó sangrado, y el 10% (n=1), afectación del tronco del encéfalo. Conclusión: En la mayoría de los pacientes con diagnóstico de leucoencefalopatía posterior reversible se evidencia señal hiperintensa en secuencias T2 y FLAIR en la sustancia blanca de lóbulos occipitales y parietales, sin representación en la secuencia de difusión. Sin embargo, puede afectar otros territorios, presentar edema citotóxico, hemorragia y no ser reversible. Estos hallazgos atípicos conllevan un peor pronóstico y por ende una mayor mortalidad. Un adecuado análisis de las imágenes es importante para confirmar la sospecha clínica y establecer una terapéutica precoz.Purpose: To make a review of the Posterior Reversible Leukoencephalopathy Syndrome making emphasis on atypical imaging findings. Materials and methods: Ten patients (n:10) were studied retrospectively, six of them women and four men of ages between seven and eighty four (mean age: 40.6). The exams were performed with a multislice CT scanner (Siemens Sensation 16, Erlangen, Germany) and two MRI units (Magnetom Symphony 1.5T and Magnetom Impact 1T, Erlangen, germany) between October 2000 and May 2007. Results: Out of ten (n=10) patients evaluated, 40% (n= 4) presented citotoxic edema (DWI hyperintensity), 70% (n= 7) compromise of the anterior circulation, 20% (n= 2) showed haemorrhage, and 10% (n= 1) brainstem involvement. Conclusion: Usual findings in Posterior Reversible Leukoencephalopathy are bilateral T2 and FLAIR hyperintensity in occipital and parietal white matter, without abnormalities in DWI. However, in some cases, other territories can be affected, citotoxic edema or haemorrhage may be present and the affection can be irreversible. These atipical findings are associated with a worse outcome and grater mortality. An appropiate imaging analysis is important to confirm clinical presumption and establish an early therapy