Pneumococcal vaccination in celiac disease

Introduction: Celiac disease (CD) is an immune-mediated disorder associated with gluten exposure in genetically predisposed subjects. Areas covered: Infectious disease is one of the causes of morbidity and mortality in CD patients. Invasive streptococcus pneumoniae (pneumococcus) is a particularly dangerous morbid condition in both the general population and celiac patients. Pneumococcal vaccination is the most effective means for its prevention. Expert opinion: In CD, evaluation of spleen function should be useful to select patients who may benefit from vaccination to reduce the risk of pneumococcal disease. Different strategies could be employed: physicians could search for signs of hyposplenism on peripheral blood smear or abdominal ultrasound. However, the best strategy to identify which patients will benefit from pneumococcal vaccination has not yet been defined

Validation of p53 Immunohistochemistry (PAb240 Clone) in Canine Tumors with Next-Generation Sequencing (NGS) Analysis

In human medicine, p53 immunohistochemistry (IHC) is a common method that is used for the identification of tumors with TP53 mutations. In veterinary medicine, several studies have performed IHC for p53 in canine tumors, but it is not known how well it actually predicts the mutation. The aim of this study was to estimate the accuracy of the IHC method for p53 (clone PAb240) using a lab-developed NGS panel to analyze TP53 mutations in a subset of malignant tumors in dogs. A total of 176 tumors were analyzed with IHC and then 41 were subjected to NGS analysis; among them, 15 were IHC positive and 26 were negative, and 16 out of 41 (39%) were found to be inadequate for NGS analysis. Excluding the non-evaluable cases at NGS, of the remaining eight IHC-positive cases, six were mutants and two were wild-type. Among the 17 IHC-negative cases, 13 were wild type, and 4 were mutants. The sensitivity was 60%, specificity was 86.7%, and the accuracy was 76%. These results suggest that when using IHC for p53 with this specific antibody to predict mutation, up to 25% wrong predictions can be expected

Cardiovascular risk/benefit profile of MHT

Background and Objectives: Data emerging from the Women's Health Initiative (WHI) study point toward an association between menopausal hormone therapy (MHT) and cardiovascular (CV) risk. However, post hoc subgroup analyses stratifying participants according to their age and time since menopause, have opened the way to a better understanding of the relationship between estrogen and CV risk. The aim of this review was to revise the current literature and evaluate the CV risk or benefit following administration of MHT considering several factors such as MHT timing, dose, route of administration, and formulation. Materials and Methods: An electronic databases search of MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, congress abstracts, and Grey literature (Google Scholar; British Library) was performed, with the date range from each database's inception until June 2019. All the studies evaluating MHT and cardiovascular risk, including thromboembolism or stroke, were selected. Results: Timing of MHT initiation was shown to be a critical factor in CV risk assessment. In concordance with the \u201ctiming hypothesis\u201d, healthy symptomatic women who initiated MHT when aged younger than 60 years, or who were within 10 years of menopause onset, have demonstrated a reduction in both coronary heart disease (CHD) risk and all-cause mortality. In particular, MHT therapy was associated with improvement of subclinical signs of atherosclerosis. Venous thromboembolism (VTE) risk is reduced when low doses of oral estrogen are used. Moreover, transdermal hormonal application significantly reduces CV risk compared with oral administration. MHT impact on the CV system is influenced by either factors inherent to the specific regimen, or factors inherent to the specific patient. Hence, individualization of care is necessary. Conclusion: CV risk calculation should be considered by clinicians in order to exclude patients with high CV risk, in whom MHT is contraindicated. Assessing risks and benefits in a patient-centered approach according to individual's features, health status, and personal preferences is important in order to realize a safe and effective treatment

Using network analysis to identify seasonal patterns and key nodes for risk-based surveillance of pig diseases in Italy

The description of the pattern of livestock movements between herds provides essential information for both improving risk-based surveillance and to understand the likely spread of infectious diseases. This study provides a description of the temporal pattern of pig movements recorded in Italy on a 4-year period (2013–2016). Data, provided by the National Livestock registry, were described by social network analysis and the application of a walk-trap algorithm for community detection. Our results show a highly populated community located in Northern Italy, which is the focal point of the Italian industrial pig production and as a general pattern an overall decline of medium and backyard farms and an increase in the number of large farms, in agreement with the trend observed by other EU pig-producing countries. A seasonal pattern of all the parameters evaluated, including the number of active nodes in both the intensive and smaller production systems, emerged: that is characterized by a higher number of movements in spring and autumn, linked with the breeding and production cycle as pigs moved from the growing to the finishing phase and with periods of increased slaughtering at Christmas and Easter. The same pattern was found when restricting the analysis to imported pig batches. Outbreaks occurring during these periods would have a greater impact on the spread of infectious diseases; therefore, targeted surveillance may be appropriate. Finally, potential super-spreader nodes have been identified and represent 0.47% of the total number of pig holdings (n = 477). Those nodes are present during the whole study period with a similar ranking in their potential of being super-spreaders. Most of them were in Northern Italy, but super-spreaders with high mean out-degree centrality were also located in other Regions. Seasonality, communities and super-spreaders should be considered when planning surveillance activity and when applying disease control strategies

EU-Approved Rapid Tests for Bovine Spongform Encephalopathy Detect Atypical Forms: A Study for Their Sensitivities

Since 2004 it become clear that atypical bovine spongiform encephalopthies (BSEs) exist in cattle. Whenever their detection has relied on active surveillance plans implemented in Europe since 2001 by rapid tests, the overall and inter-laboratory performance of these diagnostic systems in the detection of the atypical strains has not been studied thoroughly to date. To fill this gap, the present study reports on the analytical sensitivity of the EU-approved rapid tests for atypical L-and H-type and classical BSE in parallel. Each test was challenged with two dilution series, one created from a positive pool of the three BSE forms according to the EURL standard method of homogenate preparation (50% w/v) and the other as per the test kit manufacturer's instructions. Multilevel logistic models and simple logistic models with the rapid test as the only covariate were fitted for each BSE form analyzed as directed by the test manufacturer's dilution protocol. The same schemes, but excluding the BSE type, were then applied to compare test performance under the manufacturer's versus the water protocol. The IDEXX HerdChek (R) BSE-scrapie short protocol test showed the highest sensitivity for all BSE forms. The IDEXX (R) HerdChek BSE-scrapie ultra short protocol, the Prionics (R) - Check WESTERN and the AJ Roboscreen (R) BetaPrion tests showed similar sensitivities, followed by the Roche (R) PrionScreen, the Bio-Rad (R) TeSeE (TM) SAP and the Prionics (R) - Check PrioSTRIP in descending order of analytical sensitivity. Despite these differences, the limit of detection of all seven rapid tests against the different classes of material set within a 2 log(10) range of the best-performing test, thus meeting the European Food Safety Authority requirement for BSE surveillance purposes. These findings indicate that not many atypical cases would have been missed surveillance since 2001 which is important for further epidemiological interpretations of the sporadic character of atypical forms

What's in a Sign? Trademark Law and Economic Theory

Abstract: The aim of this paper is to summarise the extant theory as it relates to the economics of trademark, and to give some suggestions for further research with reference to distinct streams of literature. The proposed line of study inevitably looks at the complex relationship between signs and economics. Trademark is a sign introduced to remedy a market failure. It facilitates purchase decisions by indicating the provenance of the goods, so that consumers can identify specific quality attributes deriving from their own, or others', past experience. Trademark holders, on their part, have an incentive to invest in quality because they will be able to reap the benefits in terms of reputation. In other words, trademark law becomes an economic device which, opportunely designed, can produce incentives for maximising market efficiency. This role must, of course, be recognised, as a vast body of literature has done, with its many positive economic consequences. Nevertheless, trademark appears to have additional economic effects that should be properly recognized: it can determine the promotion of market power and the emergence of rent-seeking behaviours. It gives birth to an idiosyncratic economics of signs where very strong protection tends to be assured, even though the welfare effects are as yet poorly understood. In this domain much remains to be done and the challenge to researchers is open

Daniel Hal\ue9vy: le dittature di massa e l' "accelerazione della storia"

Daniel Hal\ue9vy (1872-1962) sostiene che a partire dalla rivoluzione industriale inglese e dalla rivoluzione francese l'"andatura del tempo" si \ue8 fatta pi\uf9 rapida e le masse urbane sono diventate fattore ineliminabile di un processo che travolge le libert\ue0 individuali e dei corpi intermedi delle societ\ue0 "modernizzate" aprendo la strada alle dittature di massa. La democratizzazione delle societ\ue0 del XX secolo \ue8 soltanto un aspetto del trionfo della tirannide della maggioranza che si identifica in figure carismatiche