An alcohol-acid resistant backache

We reported the case of a Pakistani young man, illegally residing in Italy, complaining for chronic backache. X-ray was negative, while the blood test revealed neutrophilic leukocytosis and an increase in inflammation markers. Tuberculin skin test was negative. He worsened despite of repeated cycles of analgesic therapy and fluoroquinolones. After 4 months a nuclear magnetic resonance suggested tubercular (TB) spondylitis whose etiology was confirmed by ex-juvantibus criteria. It is important to take TB in account when facing an immigrant suffering from backache, coming from a highly endemic area

An alcohol-acid resistant backache

We reported the case of a Pakistani young man, illegally residing in Italy, complaining for chronic backache. X-ray was negative, while the blood test revealed neutrophilic leukocytosis and an increase in inflammation markers. Tuberculin skin test was negative. He worsened despite of repeated cycles of analgesic therapy and fluoroquinolones. After 4 months a nuclear magnetic resonance suggested tubercular (TB) spondylitis whose etiology was confirmed by ex-juvantibus criteria. It is important to take TB in account when facing an immigrant suffering from backache, coming from a highly endemic area

Micellar effect upon the rate of alkaline hydrolysis of carboxylic and carbonate esters

AbstractThe alkaline hydrolysis of carboxylate (1-naphthylbutyrate) and carbonate esters (2-(methylsulfonyl)-ethyl-4-nitrophenylcarbonate) in the presence of different surfactants has been studied. The rate of hydrolysis of these esters was determined under pseudo first order condition in which the concentration of NaOH was kept in large excess over the [ester]. The cationic micelles of cetyltrimethylammonium bromide (CTABr) and cetyltrimethylammonium sulfate ((CTA)2SO4) enhanced the rate of hydrolysis of esters to a maximum value and thereafter, the increasing concentration of surfactant decreased the reaction rate. The anionic micelles of sodium dodecyl sulfate (SDS) inhibited the rate of the hydrolysis. The reaction proceeds through the attack of OH− ions on the carbonyl carbon forming tetrahedral intermediate. The tetrahedral intermediate is unstable and collapses immediately to yield respective acid and alcohol. The micelles influence the stability of tetrahedral intermediate, in turn, altering the rate of hydrolysis. The variation in the rate of hydrolysis by micelles was treated by considering the pseudophase ion-exchange model and Menger–Portnoy model. The added salts viz. NaBr, NaCl, and LiCl inhibited the rate of the reaction in the presence of cationic and anionic micelles. The kinetic parameters i.e. km and Ks were determined from the rate–[surfactant] profile

HIV Infection among Illegal Migrants, Italy, 2004–2007

To determine HIV prevalence and place of exposure for illegal migrants in Italy, we tested 3,003 illegal adult migrants for HIV; 29 (0.97%) were HIV positive. Antibody avidity index results (indicators of time of infection) were available for 27 of those persons and showed that 6 (22.2%) presumably acquired their infection after migration

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Migration and chronic noncommunicable diseases: Is the paradigm shifting?

In their commentary, the Authors comment upon the increasing incidence of non-communicable diseases in migrants from low income countries travelling to affluent western industrialized countrie

Consequences of the COVID-19 pandemic on the continuum of care in a cohort of people living with HIV followed in a single center of Northern Italy

During the COVID-19 pandemic, hospitals faced increasing pressure, where people living with HIV risked to either acquire SARS-CoV-2 and to interrupt the HIV continuum of care

Xpert MTB/RIF as add-on test to microscopy in a low tuberculosis incidence setting

10nonenoneSulis, G; Agliati, A; Pinsi, G; Bozzola, G; Foccoli, P; Gulletta, M; Caligaris, S; Tomasoni, LR; El-Hamad, I; Matteelli, A;Sulis, G; Agliati, A; Pinsi, G; Bozzola, G; Foccoli, P; Gulletta, M; Caligaris, S; Tomasoni, Lr; El-Hamad, I; Matteelli,