Il caso Semmelweis. La tragica storia di uno scienziato eretico

The paper retraces the singular and dramatic personal and professional vicissitudes of the Hungarian physician Ignaz Philipp Semmelweis, who in order to fight the puerperal fevers, faced the medical establishment of the time and the dominant scientific paradigm, ending up being tragically misunderstood and marginalized. According to Khun’s model, Semmelweis, unfortunately, was a revolutionary doctor in a phase of ‘normal science’

Hypervirulent antibiotic-resistantClostridium difficilein Europe

Recently, several Clostridium difficile outbreaks due to PCR ribotype 027, associated with increased disease severity and death, have been reported in North America and in several European countries. This strain is toxinA/toxinB-positive, contains the genes for binary toxin and has an 18 bp deletion and a frameshift mutation in the gene tcdC hypothesized to result in a deregulated expression of toxins A and B. These strains are high producers of toxins in vitro compared with other toxinotypes. Moreover, these strains show a high level of resistance to fluoroquinolones, possibly due to the presence of a transition mutation (C to T) in the gyr A, resulting in the amino acid substitution Th82->IIe. A 2 month prospective study was conducted in 38 hospitals in 14 different European countries to get an overview of the phenotypic and genotypic features of C. difficile isolates in 2005. In all, 411 isolates of C. difficile were obtained from diarrhoeic patients with suspected C. difficile -associated diarrhoea (CDAD); the prevalence of the 027 epidemic strain was 6.2%. All 027 strains were positive for binary toxin genes, had an 18 bp deletion in tcdC gene and were resistant to erythromycin and moxifloxacin. Patients infected with an 027 strain were likely to have a more severe disease (OR=2.52, 95% CI 0.92-6.85, p=0.04) and to have been more specifically treated by metronidazole or vancomycin (OR=7.23, CI 0.99-149, p=0.02). Ongoing epidemiological surveillance of CDAD cases with periodic characterization of the strains is needed to detect clustering of cases in time and space and to monitor the emergence of a specific hypervirulent clone. Key words: Clostridium difficile, toxins A and B, hypervirulence, C. difficile-associated diarrhoe

The professional skills profile of a public affairs practitioner in Spain

Purpose: The present study identifies the professional skills profile that a Public Affairs (PA) practitioner of a major company or an organization representing the interests of various economic sectors should have in Spain. Design/methodology: The study uses a mixed qualitative and quantitative methodology. The initial identification of the competences, as well as the general functions of the profile to be evaluated, has been carried out using the in-depth interview technique with the directors of APRI (Association of Professionals of Institutional Relations of Spain), who defined these competencies from their expert perspective. Subsequently, through a survey of seventy-two managers, sufficient data were obtained to statistically process the information and obtain significant results in the identification of such competences. This information has been processed, firstly, through factorial analysis, which has made it possible to synthesize these competences. Once the analysis of factors was carried out, a cluster analysis is added for the classification of the respondents or managers. Findings: The perception of the interviewed executives has been determined regarding the functions that an institutional relations practitioner must fulfill. It should be noted that this is a profession for which there is no clarity about the role and the legitimacy of its members, particularly in Spain. In fact, it is associated with a function that is seen as exerting undue pressure on political power. A field study was conducted to determine the opinion of these managers on the competences that a professional in institutional relations should have. Originality/value: This study provides a description of the job position of a person responsible for institutional relations in Spain. Moreover, it adds a typology of managers, according to the competences defined for the person responsible for institutional relations.Peer Reviewe

Clostridium difficile erm(B)-containing elements and the burden on the in vitro fitness

In Clostridium difficile, resistance to the macrolide-lincosamide-streptogramin B group of antibiotics generally relies on erm(B) genes. In this study, we investigated elements with a genetic organization different from Tn5398, the mobilizable non-conjugative element identified in C. difficile strain 630. Our results suggested that the elements most frequently found in strains isolated during the European surveillance study in 2005 were related to Tn6194, the conjugative transposon recently detected in different C. difficile types, including PCR-ribotype 027. We characterized a Tn6194-like and a novel element rarely found in clinical isolates. A burden on the in vitro fitness of C. difficile was observed after the acquisition of these elements as well as of Tn5398

Enteric Toxins from Bacteria Colonizing Human Gut

The large and heterogeneous microbial population colonising the human intestinal tract includes a number of aerobic and anaerobic bacteria that produce one or more toxins. While exhibiting very different physico-chemical properties these exotoxins share the ability to penetrate intestinal cells after their binding to a specific surface receptor, thus reaching a subcellular target at membrane or cytoskeleton level. The most relevant in vitro and in vivo data, reported in the literature, on the mode of action of the major enterotoxins and cytotoxins produced by bacteria belonging to the human gut microora are reviewed in the light of our recent knowledge on bacteria-host cell interactions

Variation in expression of HMW1 and HMW2 adhesins in invasive nontypeable Haemophilus influenzae isolates

<p>Abstract</p> <p>Background</p> <p>Among surface antigens of nontypeable <it>Haemophilus influenzae </it>(NTHi), the HMW1 and HMW2 proteins are the major adhesins promoting colonization of the upper respiratory tract. Since they are potential vaccine candidates, knowledge concerning variation in HMW proteins expression among clinical isolates is of great interest. In this study, expression of <it>hmw1A </it>and <it>hmw2A </it>genes was evaluated by quantitative real-time reverse transcription-PCR in 3 NTHi invasive isolates (strains 56, 72, 91) and in the prototype strain 12. Number of 7-bp repeats within the <it>hmwA </it>promoters and presence of HMW proteins by Western blotting were also determined.</p> <p>Results</p> <p>Results showed that gene transcription varied not only among different isolates but also between the <it>hmw1A </it>and <it>hmw2A </it>genes from the same isolate. Compared to that found in prototype strain 12, up-regulation of the <it>hmw1A </it>gene expression was found in strain 56, down-regulation of both <it>hmw1A </it>and <it>hmw2A </it>genes transcripts was observed in strain 72 whereas the two <it>hmwA </it>genes appeared differentially expressed in strain 91 with the <it>hmw1A </it>transcript enhanced but the <it>hmw2A </it>transcript reduced.</p> <p>Conclusion</p> <p>Increasing numbers of 7-bp repeats within the <it>hmwA </it>promoters generally correlated with decreased amounts of mRNA transcript, however additional control mechanisms contributing to modulation of <it>hmw1A </it>gene seem to be present.</p

Predicting procrastination with academic performance: Towards the anticipation of a higher education problem

Purpose: With the purpose of predicting the problem of procrastination, we study how age, sex, type of studies and grade for admission to higher education influence the procrastination behavior of students. Design/methodology/approach: In a sample of 359 university students, the Pure Procrastination scale was applied, as well as data on sex, age, grade previous to join the university, grade completed and year of study (first to fourth). To identify underlying variables or factors that explain the configuration of correlations in the items of the scale used, an exploratory factor analysis was carried out (principal component analysis with Varimax normalization). Next, a multiple linear regression analysis was performed with the variables sex, age, and admission grade as independent variables and academic procrastination as the dependent variable. Findings: It has been possible to identify the variables that influence the procrastinating behavior of university students. From the identification of which students will possibly present procrastinating behaviors, the people responsible for university education will be able to implement intervention programs to deal with procrastination. Research limitations/implications: The sample is not representative of the universe of university students, although the results obtained are relevant enough to replicate the study in other university contexts. Our data could have included more instruments for collecting information, which in future studies would entail incorporating scales related to the perception of time management, motivation or self-regulation. Practical implications: Distinguishing, among university students, those who may present more procrastination tendencies will guide those responsible for the educational process of said students with respect to measures to alleviate the negative effects of procrastination through psycho-socio-educational intervention programs. Social implications: The knowledge derived from this work has practical implications for the students themselves who, in the case of being identified as a potential procrastinator, may benefit from a psycho-socio educational intervention that will help them manage their time and reduce the discomfort derived from the procrastination. Originality/value: On the previous corpus of existing scientific knowledge, this work provides knowledge that allows optimizing, both at a public and private level, the academic, economic and social resources of university institutions in which procrastination can affect the preparation and the student performance

Characterisation of Neisseria meningitidis C strains causing two clusters in the north of Italy in 2007 and 2008.

Two clusters of invasive meningococcal disease in the north of Italy both due to serogroup C/ST-11 clonal complex are here described. The objective of the investigation was to analyse the phenotype and the genotype of meningococci involved in the two clusters which were of national relevance due to the fatal outcome of the majority of cases (six of the total of 10 cases). All the strains were C:2a:P1.5 ST-11/ET-37 clonal complex. Two pulsed field gel electrophoresis (PFGE) and variable number tandem repeats (VNTR) profiles were identified, one for each cluster. VNTRs were different from those detected in Italy for C/ST-11 strains isolated from sporadic cases in the same period. This laboratory surveillance report highlights the importance and the crucial role of molecular characterisation to confirm the relatedness among meningococci responsible for clusters of cases