Congenital Chagas disease in a Bolivian newborn in Bergamo (Italy)

Chagas disease (CD) is an uncommon disease in Europe. Its epidemiology has changed because of mass migration from Latin America to Europe. Herein we describe a congenital case of CD in a Bolivian newborn in Bergamo, the main city of residence for the Bolivian community in Italy. At delivery, serological analyses evidenced IgG antibodies against Trypanosoma cruzi both in the child and mother, as expected. Hemoscopic analyses on peripheral blood were repeatedly negative during the first months of life. Eventually, thanks to T. cruzi Real Time polymerase chain reaction (RT-PCR) positivity on peripheral blood and development of progressive anemia in the following weeks, congenital Chagas disease was diagnosed and benznidazole-based therapy started. A progressive antibodies' index decrease was observed till negativity (306 days apart). RT-PCR was negative at the end of treatment. Our case is instructive and management of congenital CD is discussed from the perspective of a non-endemic country

Canine Babesioses in noninvestigated areas of Serbia

During the years 2012-2014, a total of 158 outdoor dogs from Pančevo and Đurđevo (northern Serbia) and Niš and Prokuplje (southern Serbia) were submitted to molecular analyses (PCR and sequencing) for canine babesioses. An overall prevalence of 21.5% was found, due to the species Babesia sp. 'spanish dog' (10.1%), B. gibsoni (5.7%), B. canis vogeli (1.9%), B. caballi (1.9%), and B. microti (1.9%). In addition, sequence analysis showed the presence of Hepatozoon canis in a dog from Niš. No significant difference between infected and noninfected dogs was found by age, sex, and place of residence, whereas there was difference regarding the presence of ticks (p<0.005) and application of preventive measures such as applying of antitick drugs/devices. Moreover, a significant difference was established by area: Dogs from Prokuplje showed infection rates (59.1%) higher than dogs from Pančevo (11.9%), Niš (4.5), and Đurđevo (where infected dogs were not found), and a different geographical distribution of the species was found. The presence of so many Babesia species and the first identification of H. canis will allow investigations on the pathogenic role played by each one and suggests entomological studies on the tick species that are more suitable vectors for each of them. Finally, the presence of so many infected dogs offers the opportunity of evaluating the hypothesis of a possible zoonotic role of babesial species affecting dogs

Malaria in an asylum seeker paediatric liver transplant recipient: diagnostic challenges for migrant population

Transplanted patients are particularly exposed to a major risk of infectious diseases due to prolonged immunosuppressive treatment. Over the last decade, the growing migration flows and the transplant tourism have led to increasing infections caused by geographically restricted organisms. Malaria is an unusual event in organ transplant recipients than can be acquired primarily or reactivation following immunosuppression, by transfusion of blood products or through the transplanted organ. We report a rare case of Plasmodium falciparum infection in a liver transplanted two years-old African boy who presented to one Italian Asylum Seeker Center on May 2019. We outlined hereby diagnostic challenges, possible aetiologies of post-transplantation malaria and finally we summarized potential drug interactions between immunosuppressive agents and antimalarials. This report aims to increase the attention to newly arrived migrants, carefully evaluating patients coming from tropical areas and taking into consideration also rare tropical infections not endemic in final destination countries

Chronic polyarthritis associated to Cercopithifilaria bainae infection in a dog.

Despite the widespread distribution of Cercopithifilaria bainae among canine and tick populations worldwide, this filarioid is currently considered of 'minor importance' in veterinary medicine, particularly when compared to related filarioids, such as Dirofilaria immitis and Dirofilaria repens. To date, only a single case of dermatological alterations possibly associated to infection by C. bainae had been reported in a dog. In the present study, we describe the first case of systemic alterations associated to C. bainae infection in a dog suffering from diffused chronic polyarthritis. The animal had a previous history of reluctance to move and stiff gait and displayed multiple joint pain during manipulation of limbs. No biochemical, haematological and X-ray alterations were detected; microfilariae were observed in the synovial fluids collected from the joints. In spite of the morphological and molecular identification of these microfilariae as C. bainae, the dog did not respond to multiple microfilaricidal treatments with milbemicyn oxyme. The potential role of C. bainae in the pathogenesis of this clinical condition is discussed. Given the potential pathogenicity of this parasite, improved knowledge of this little known tick-borne nematode is warranted in order to assist the development of novel and effective treatment strategies.This is the author accepted manuscript. The final version can be found on the publisher's website at: http://www.sciencedirect.com/science/article/pii/S0304401714003744# © 2014 Published by Elsevier B.V

Analisi molecolare dei geni implicati nelle mucopolisaccaridosi: valutazione della casistica di uno studio multicentrico.

Introduzione Nell'ambito di un Progetto PRIN, sono state rivalutate le diagnosi molecolari dei pazienti arruolati nello studio, per un totale di 60 soggetti, affetti da diverse forme di MPS. Metodi I dati genetici dei singoli pazienti, resi disponibili dalle diverse Unità Cliniche, sono stati ri-analizzati. Le varianti sono state ri-annottate secondo l'annotazione HGVS corrente. Risultati La diagnosi molecolare è risultata disponibile per 50 dei 60 pazienti. Per i 10 pazienti non caratterizzati era disponibile l'analisi enzimatica, sulla quale si era basata la formulazione della diagnosi di malattia. Sono state identificate 86 varianti causanti patologia (55 diverse). Il 70% erano missenso, 11.6% non senso e una variante senso; il 9.3% erano ampie delezioni/riarrangiamenti, il 3.5% piccole delezioni/inserzioni, il 4.6% varianti di splicing. Nove varianti non erano riportate in letteratura. Una spiccata disomogeneità nell'annotazione delle varianti è risultata evidente; ciò è imputabile al fatto che l'analisi genetica di molti pazienti risale a periodi storici diversi, in cui erano in vigore regole di annotazione differenti. Tale aspetto potrebbe causare difficoltà nell'interpretazione delle varianti, con inevitabili ricadute sulla consulenza genetica. Discussione Lo studio evidenzia la necessità di completare la diagnosi molecolare nei pazienti MPS già diagnosticati in passato con procedure di tipo biochimico. Emerge poi la necessità di aggiornare periodicamente l'annotazione delle varianti e di depositarle presso database dedicati (LOVD , ClinVAr, ecc.) in modo da renderle disponibili alla comunità scientifica. E' necessario, inoltre, stabilire un percorso diagnostico-molecolare condiviso, che preveda anche la ricerca delle varianti nei genitori per facilitare la diagnosi e consentire di identificare anche le varianti de novo, che richiedono un diverso percorso di consulenza

Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina

Background Previous studies showed that troponin blood levels may increase after exercise. In this study we assessed whether, among patients admitted with suspected unstable angina, the increase in high-sensitive troponin T (hs-TnT) levels after exercise stress test (EST) might help identify those with obstructive coronary artery disease (CAD) and predict symptom recurrence during short term follow-up. Methods Maximal treadmill EST was performed in 69 consecutive patients admitted to the emergency room with a suspicion of unstable angina (acute chest pain but confirmed normal serum levels of cardiac troponins) was measured before and 4 hours after EST. Coronary angiography was performed in 22 patients (32.8%). Results hs-TnT increased after EST compared to baseline in the whole population (from 0.84\ub10.65 to 1.17\ub10.87 ng/dL, p&lt;0.001). The increase was similar in patients with positive (n = 14) and negative (n = 55) EST (p = 0.72), and was also similar in patients with (n = 12) and without (n = 10) obstructive CAD at angiography (p = 0.91). The achievement of a heart rate at peak EST \ufffd85% of that predicted for age was the variable mainly associated with the post- EST hs-TnT increase at multivariable linear regression analysis (p = 0.005). The change after EST of hs-TnT did not predict the recurrence of symptoms or readmission for chest pain at 6-month follow-up. Conclusions Our data show that hs-TnT increased after EST in patients with suspected unstable angina, which seemed largely independent of most clinical and laboratory variables. Thus, hs-TnT assessed after EST does not seem to be helpful to identify patients with obstructive CAD in this kind of patients

Consensus statement on the diagnosis and treatment of sclerosing diseases of the skin, Part 2: Scleromyxoedema and scleroedema

The term 'sclerosing diseases of the skin' comprises specific dermatological entities, which have fibrotic changes of the skin in common. These diseases mostly manifest in different clinical subtypes according to cutaneous and extracutaneous involvement and can sometimes be difficult to distinguish from each other. The present consensus provides an update to the 2017 European Dermatology Forum Guidelines, focusing on characteristic clinical and histopathological features, diagnostic scores and the serum autoantibodies most useful for differential diagnosis. In addition, updated strategies for the first- and advanced-line therapy of sclerosing skin diseases are addressed in detail. Part 2 of this consensus provides clinicians with an overview of the diagnosis and treatment of scleromyxoedema and scleroedema (of Buschke)

Circulating miR-320b and miR-483-5p levels are associated with COVID-19 in-hospital mortality

none28noThe stratification of mortality risk in COVID-19 patients remains extremely challenging for physicians, especially in older patients. Innovative minimally invasive molecular biomarkers are needed to improve the prediction of mortality risk and better customize patient management. In this study, aimed at identifying circulating miRNAs associated with the risk of COVID-19 in-hospital mortality, we analyzed serum samples of 12 COVID-19 patients by small RNA-seq and validated the findings in an independent cohort of 116 COVID-19 patients by qRT-PCR. Thirty-four significantly deregulated miRNAs, 25 downregulated and 9 upregulated in deceased COVID-19 patients compared to survivors, were identified in the discovery cohort. Based on the highest fold-changes and on the highest expression levels, 5 of these 34 miRNAs were selected for the analysis in the validation cohort. MiR-320b and miR-483-5p were confirmed to be significantly hyper-expressed in deceased patients compared to survived ones. Kaplan-Meier and Cox regression models, adjusted for relevant confounders, confirmed that patients with the 20% highest miR-320b and miR-483-5p serum levels had three-fold increased risk to die during in-hospital stay for COVID-19. In conclusion, high levels of circulating miR-320b and miR-483-5p can be useful as minimally invasive biomarkers to stratify older COVID-19 patients with an increased risk of in-hospital mortality.restrictedGiuliani, Angelica; Matacchione, Giulia; Ramini, Deborah; Di Rosa, Mirko; Bonfigli, Anna Rita; Sabbatinelli, Jacopo; Monsurrò, Vladia; Recchioni, Rina; Marcheselli, Fiorella; Marchegiani, Francesca; Piacenza, Francesco; Cardelli, Maurizio; Galeazzi, Roberta; Pomponio, Giovanni; Ferrarini, Alessia; Gabrielli, Armando; Baroni, Silvia Svegliati; Moretti, Marco; Sarzani, Riccardo; Giordano, Piero; Cherubini, Antonio; Corsonello, Andrea; Antonicelli, Roberto; Procopio, Antonio Domenico; Ferracin, Manuela; Bonafè, Massimiliano; Lattanzio, Fabrizia; Olivieri, FabiolaGiuliani, Angelica; Matacchione, Giulia; Ramini, Deborah; Di Rosa, Mirko; Bonfigli, Anna Rita; Sabbatinelli, Jacopo; Monsurrò, Vladia; Recchioni, Rina; Marcheselli, Fiorella; Marchegiani, Francesca; Piacenza, Francesco; Cardelli, Maurizio; Galeazzi, Roberta; Pomponio, Giovanni; Ferrarini, Alessia; Gabrielli, Armando; Baroni, Silvia Svegliati; Moretti, Marco; Sarzani, Riccardo; Giordano, Piero; Cherubini, Antonio; Corsonello, Andrea; Antonicelli, Roberto; Procopio, Antonio Domenico; Ferracin, Manuela; Bonafè, Massimiliano; Lattanzio, Fabrizia; Olivieri, Fabiol