Hospitalizations for pertussis in Italy, 1999-2009: analysis of the hospital discharge database.

Even if the incidence of pertussis has greatly decreased after the adoption of immunization, it still remains a relevant cause of death in infants in their first years of life. At national level, data are usually greatly underestimated. The objective of this study was to retrospectively review the national hospital discharge form database. The national database was retrospectively searched using the International Classification of Diseases, ninth revision, Clinical Modification system. In the period 1999-2009, 7,768 hospitalizations for pertussis (primary diagnosis) have been registered: 6,971 hospitalizations and 797 day hospital admissions. The annual mean was equal to 633.6 hospitalizations and 72.4 day hospital admissions. The majority of hospitalizations (57.4 %) involved subjects <1 year of age; the mean duration of stay was about 6 days. Conclusion These data, even if restricted to hospitalizations registered at national level, confirm the epidemiological impact of pertussis and its complications in a country with a consistently high vaccination coverage ra

A Calcified Mass in the Spinal Canal of a Patient With [beta]-thalassemia Major

A 39 year old thalassemia patient with leg weakness, reduced thermodolorific sensitivity, and edema of feet and ankles, for 3 months, underwent thoracolumbar computed tomography scan, which showed an extramedullary mass with a spinal cord compression from D4 to D5. Magnetic resonance could not be performed because the patient carried a pacemaker. Scintigraphy with Tc99 excluded functioning extramedullary erythropoietic tissue. Therapeutic decompressive laminectomy was performed and diagnosis of psammomatous meningioma was made. Symptoms slowly regressed

Vitamina D: è indispensabile... ma non esageriamo!

Descriviamo un caso di ipercalcemia severa in corso di ipervitaminosi D in un lattante di 5 mesi allattato con formula standard e supplementato con 2 gtt di calcifediolo al giorno dalla nascita. Il quadro clinico era caratterizzato da deflessione della curva staturo-ponderale, inappetenza e disidratazione, ipotonia assiale con rallentamento dello sviluppo psico-motorio, fontanella anteriore chiusa. Le indagini hanno evidenziato soppressione del paratormone, marcata ipercalciuria, livelli elevati di 25-OH vitamina D3 e un reperto ecografico compatibile con nefrocalcinosi di primo grado. Il quadro clinico si è risolto con idratazione endovenosa, trattamento orale con prednisone e citrato di potassio, sospensione della supplementazione vitaminica e sostituzione del latte artificiale con una formula a basso contenuto di calcio e priva di vitamina D. Il caso è emblematico per scoraggiare l’utilizzo di forme attivate di vitamina D3 nella profilassi dell’ipovitaminosi D in età pediatrica

Serum antibodies from epileptic patients react, at high prevalence, with simian virus 40 mimotopes

Background and purpose: It has been demonstrated that inflammation may contribute to epileptogenesis, and cause neuronal injury in epilepsy. In this study, the prevalence of antibodies to Simian virus 40, a kidney- and neurotropic polyomavirus, was investigated in serum samples from 88 epileptic children/adolescents/young adults. Methods: Serum antibodies reacting to specific SV40 peptides were analysed by indirect ELISA. Synthetic peptides corresponding to the epitopes of viral capsid proteins 1-3 were used as SV40 antigens. Results: A significantly higher prevalence of antibodies against SV40 was detected in sera from epileptic patients when compared to controls (41% vs. 19%). Specifically, the highest significant difference was revealed in the cohort of patients from 1.1-10 years old (54% vs. 21%), with a peak in the sub-cohort of 3.1-6 years old (65% vs. 18%). Conclusion: Our immunologic data suggest a strong association between epilepsy and the SV40 infection

Antibodies reacting with Simian Virus 40 mimotopes in serum samples from thalassaemia major patients.

Background. Simian virus 40 (SV40) is a small DNA tumour virus. Footprints of the virus have been detected in different humam lymphoproliferative disorders and in blood specimens of blood from healthy blood donors. This study was carried out to verify whether SV40 antibodies can be detected in serum samples from multiply transfused patients with thalassaemia major. Materials and methods. An indirect enzyme-linked immunosorbent assay was employed, using SV40 specific synthetic peptides mimicking the antigens of the viral capsid proteins 1-2-3, to test for the presence of antibodies to SV40 in serum samples taken from patients affected by transfusiondependent thalassaemia major (n=190) and healthy blood donors (n=251). Results. The prevalence of antibodies against SV40 was higher in patients than in controls (24% vs 17%). The prevalence increased and was significantly higher in the older age group of patients affected by thalassemia major than in controls (38% vs 20%, p<0.04). Discussion. The higher prevalence of serum antibodies against simian virus 40 in older, multiply transfused patients with thalassamia major than in controls suggests that this virus, or a closely related yet unknown human polyomavirus, could have been transmitted in the past by transfusion with whole blood. At the same time, our data indicate no significant differences in prevalence of SV40 antibodies in patients and controls of younger age thus suggesting that current transfusion methods with leucodepletion and filtered red cells are safe