Past and present prevalence of Phlebotomus papatasi (Diptera: Psychodidae) in Italy

The authors list all data reporting the presence and density of Phlebotomus papatasi (Diptera: Psychodidae) in Italy. The general conclusion is that P. papatasi is widespread and at times abundant in urban areas. Exceptional collections were made in Apulia (in old stables) and Latium (in bedrooms). In localities near Rome (Rocca Priora and Collevecchlo Sabino) and in the city of Rome as well, P. papatasi may be a nuisance, with many people suffering severe irritation from multiple bites. Two laboratory colonies of P. papatasi have been established from naturally-engorged females collected in Latium (Rocca Priora and Rome) with the aim of studying the ability of laboratory-bred females to incubate and transmit Leishmania and phleboviruses

Canine Leishmaniasis, Italy

We report the results of a survey to determine the prevalence of canine leishmaniasis and the presence of sand flies in northwestern Italy, where autochthonous foci of canine leishmaniasis have not been reported. Active foci of canine leishmaniasis were identified, which suggests that the disease is now also endemic in continental climate areas

The Impact of Crohn's Perianal Fistula on Quality of Life: Results of an International Patient Survey

Lay Summary Results from an online survey completed by patients with Crohn's disease (CD) and perianal fistulas showed the presence of perianal fistulae has a greater negative impact as compared to CD-only patients. These results may help practitioners address patient burden.Background Crohn's perianal fistula is a disabling manifestation of Crohn's disease. However, the additional burden of perianal fistula on patients with only Crohn's disease remains to be addressed. This patient-reported survey considered outcomes of two domains: "diagnosis" (eg, symptoms) and "living with the disease" (eg, quality of life, well-being, and relationships). Methods Patients with perianal fistula and Crohn's disease completed an online, self-selective, anonymous, 46-item survey available in 11 languages hosted on the European Federation of Crohn's & Ulcerative Colitis Associations and national patient association websites. The survey was conducted between July and December 2019 in Europe and other regions. Likert scales and closed questions were used to assess outcomes. Results Of the 820 respondents with Crohn's disease (67.2% women; median age, 40.0 years), 532 (64.9%) reported the presence of perianal fistula. Patients with perianal fistula reported a greater impact on overall quality of life (P < .001), well-being (P < .001), relationships (P < .001), social life (P = .001), and work life (P = .012) than patients with only Crohn's disease. Conclusions Perianal fistulas impact several domains of the life of patients with Crohn's disease. These results may help healthcare practitioners plan therapeutic strategies that address the symptomatic and psychological burden experienced by patients with perianal fistulizing Crohn's disease

Serološka i entomološka istraživanja lišmanioze u pasa u Hrvatskoj.

In Croatia, canine leishmaniosis has been recognized in the southern littoral area (Dalmatia) as a reemerging disease since 1997. This paper reports the fi ndings of a survey carried out 2.5 years after the suspension of control measures for canine leishmaniosis. Entomological and cross-sectional serological surveys were carried out in the Kaštela municipality in the Split-Dalmatia County (where stable foci of canine leishmaniosis were reported previously), and in a few localities from the Šibenik-Knin county where a few unstable foci were previously reported. Serological surveys detected a focus with 31% seropositive dogs in Rudine (the known enzootic area); a tendency for a new stable focus appearance in the Šibenik-Knin County (Rogoznica), with cumulative seropositivity of 13.5% in both areas. Entomological studies evidenced two competent Leishmania vectors, Phlebotomus neglectus and P. tobbi; the fi rst was prevalent (75.9%) being also the species much more associated to habitats where dogs are present. Moreover, prevalence for P. neglectus females feeding on human blood reached 30%.Na jugu hrvatskoga priobalja (Dalmacija) lišmanioza pasa u ponovnom je porastu od 1997. godine. U ovom radu izneseni su rezultati istraživanja provedenih 2,5 godine nakon ukidanja obveznih mjera suzbijanja lišmanioze pasa. Serološko i entomološko istraživanje provedeno je na području općine Kaštela u Splitsko-dalmatinskoj županiji (područje s poznatim stalnim žarištima pasje lišmanioze) i na nekoliko lokacija Šibensko-kninske županije gdje je zabilježeno samo povremeno javljanje lišmanioze. Serološkim je istraživanjima otkriveno žarište s 31% serološki pozitivnih pasa u Rudinama (enzootsko područje) s tendencijom nastanka novoga stalnog žarišta u Šibensko-kninskoj županiji (Rogoznica), a ukupno je bilo 13,5% serološki pozitivnih pasa. Entomološkim istraživanjima dokazana je prisutnost dviju vrsta prijenosnika koji podržavaju razvoj roda Leishmania, Phlebotomus neglectus i P. tobbi; prvi je mnogo zastupljeniji (75,9%) i češće prisutan tamo gdje ima pasa, a čak 30% pretraženih ženki P. neglectus hranilo se na ljudima

About the eastern limit of distribution of Phlebotomus ariasi (Diptera: Psychodidae)

Cette note fait part des resultats des enquetes entomologiques menees en 1995 dans les provinces de la region de Ligurie (Italie) pendant la periode d'activite des phlebotomes Un total de 2 216 phlebotomes a ete recolte dans quatre provinces en l'espace de 3 mois. Les especes suivantes ont ete identifiees : Phlebotomus perniciosus (31,8 %), P. ariasi (0,8 %) et Sergentomyia minuta (67,4 %). P. perniciosus, vecteur de leishmaniose viscerale en Italie, a ete recolte dans toutes les stations positives. Au contraire, P. ariasi a ete capture seulement dans les provinces d'Imperia et de Savona. La repartition geographique orientale de P. ariasi fait l'objet d'une discussion

About the presence of Phlebotomus sergenti Parrot, 1917 (Diptera: Psychodidae) in Eastern Sicily, Italy.

The note reports the data of a three-year sand fly investigation (1997-99) carried out in Eastern Sicily (Italy) with the aim to study the distribution of Phlebotomus sergenti. The survey involved a densely inhabited area at the foot of Mount Etna and the area of Iblei mounts. A total of 9,095 sand flies, of which 63.4 % males, were captured. Five species belonging to the genus Phlebotomus (P. perniciosus, P. perfiliewi, P. neglectus, P. sergenti and P. papatasi) and one to the genus Sergentomyia (S. minuta) were identified. Both the prevalence and distribution of the species were different within the two areas studied. In Mount Etna area, P. perniciosus (77.7 %) was the prevalent species followed by S. minuta (19.8 %), P. sergenti (2.0 %), P. neglectus (0.3 %) and P. papatasi (0.2 %). While in Iblei mounts region S. minuta (84,5 %) showed the highest prevalence, followed by P. perniciosus (14.4 %), P. perfiliewi (0,9 %) and P. neglectus (0,1 %). Here, P. sergenti was a very rare species (‹ 0.02). P. sergenti was mostly associated to domestic habitats of peri-urban and urban zones located between two and 750 m a.s.l. The density values of P. sergenti. expressed as number of specimens/m2 of sticky trap, were between 0.3 and 5.5 with the highest value in the hilly collecting sites. The low observed abundance of P. sergenti does not allow to draw any prediction on the role that the species could play in the transmission of leishmaniasis in Sicily

Detection of Leishmania infantum DNA mainly in Rhipicephalus sanguineus male ticks removed from dogs living in endemic areas of canine leishmaniosis

Background: Sand flies are the only biologically adapted vectors of Leishmania parasites, however, a possible role in the transmission of Leishmania has been proposed for other hematophagous ectoparasites such as ticks. In order to evaluate natural infection by Leishmania infantum in Rhipicephalus sanguineus ticks, taking into account its close association with dogs, 128 adult R. sanguineus ticks removed from 41 dogs living in endemic areas of canine leishmaniosis were studied. Methods: Individual DNA extraction was performed from each tick and whole blood taken from dogs. Dog sera were tested for IgG antibodies to L. infantum antigen by ELISA and L. infantum real-time PCR was performed from canine whole blood samples and ticks. Results: Leishmania infantum PCR was positive in 13 ticks (10.1%) including one female, (2.0%) and 12 males (15.2%), and in only five dogs (12.2%). Male ticks had a significantly higher infection rate when compared to female R. sanguineus. The percentage of L. infantum seroreactive dogs was 19.5%. All but two PCR positive dogs were seroreactive. Leishmania infantum PCR positive ticks were removed from seropositive and seronegative dogs with a variety of PCR results. Conclusions: This study demonstrates high prevalence of L. infantum DNA in R. sanguineus ticks removed from L. infantum seropositive and seronegative dogs. The presence of L. infantum DNA was detected mainly in male ticks possibly due to their ability to move between canine hosts and feed on several canine hosts during the adult life stage. Additional studies are needed to further explore the role of R. sanguineus ticks and in particular, male adults, in both the epidemiology and immunology of L. infantum infection in dogs in endemic areas

Minimally invasive vs. open segmental resection of the splenic flexure for cancer: a nationwide study of the Italian Society of Surgical Oncology-Colorectal Cancer Network (SICO-CNN)

Background Evidence on the efficacy of minimally invasive (MI) segmental resection of splenic flexure cancer (SFC) is not available, mostly due to the rarity of this tumor. This study aimed to determine the survival outcomes of MI and open treatment, and to investigate whether MI is noninferior to open procedure regarding short-term outcomes. Methods This nationwide retrospective cohort study included all consecutive SFC segmental resections performed in 30 referral centers between 2006 and 2016. The primary endpoint assessing efficacy was the overall survival (OS). The secondary endpoints included cancer-specific mortality (CSM), recurrence rate (RR), short-term clinical outcomes (a composite of Clavien-Dindo > 2 complications and 30-day mortality), and pathological outcomes (a composite of lymph nodes removed >= 12, and proximal and distal free resection margins length >= 5 cm). For these composites, a 6% noninferiority margin was chosen based on clinical relevance estimate. Results A total of 606 patients underwent either an open (208, 34.3%) or a MI (398, 65.7%) SFC segmental resection. At univariable analysis, OS and CSM were improved in the MI group (log-rank test p = 0.004 and Gray's tests p = 0.004, respectively), while recurrences were comparable (Gray's tests p = 0.434). Cox multivariable analysis did not support that OS and CSM were better in the MI group (p = 0.109 and p = 0.163, respectively). Successful pathological outcome, observed in 53.2% of open and 58.3% of MI resections, supported noninferiority (difference 5.1%; 1-sided 95%CI - 4.7% to infinity). Successful short-term clinical outcome was documented in 93.3% of Open and 93.0% of MI procedures, and supported noninferiority as well (difference - 0.3%; 1-sided 95%CI - 5.0% to infinity). Conclusions Among patients with SFC, the minimally invasive approach met the criterion for noninferiority for postoperative complications and pathological outcomes, and was found to provide results of OS, CSM, and RR comparable to those of open resection

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (<50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, <50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters