influenza monitoring in sardinia italy identifies h3 subtype in mediterranean wild migratory birds

Introduction: Wild migratory birds are global distributors of pathogens. Sardinia, Italy, is the second largest Island in the Mediterranean and is a land bridge between Europe and Africa. Methodology: We designed a surveillance protocol to investigate wild migratory birds for presence, frequency, and type of avian influenza viruses. We collected over 4,000 avian samples and compared three sampling methods, fecal, cloacal, and tracheal, to determine the most productive for virus identification. To determine frequency of infection, RNA was extracted and RT-PCRs for avian influenza virus genes were run. Positive samples were cultivated for live virus, sub typed and sequenced. Results: Forty-four samples were positive for influenza nucleoprotein gene. We identified two previously unidentified H3 subtype strains and found cloacae to have the highest rate of virus identification and fecal sampling to provide quality RNA and repeatable results for determination of virus presence. Conclusion: Our investigation provides information on the frequency of Mediterranean avian influenza viruses, and validates the initiation of an avian influenza surveillance protocol. Taken together with global avian influenza findings, these results give insight into infectious disease distributions which is important for viral pandemic monitoring and design of preventative measures

Ethical issues of unrelated hematopoietic stem cell transplantation in adult thalassemia patients

<p>Abstract</p> <p>Background</p> <p>Beta thalassemia major is a severe inherited form of hemolytic anemia that results from ineffective erythropoiesis. Allogenic hematopoietic stem cell transplantation (HSCT) remains the only potentially curative therapy. Unfortunately, the subgroup of adult thalassemia patients with hepatomegaly, portal fibrosis and a history of irregular iron chelation have an elevated risk for transplantation-related mortality that is currently estimated to be about 29 percent.</p> <p>Discussion</p> <p>Thalassemia patients may be faced with a difficult choice: they can either continue conventional transfusion and iron chelation therapy or accept the high mortality risk of HSCT in the hope of obtaining complete recovery.</p> <p>Throughout the decision making process, every effort should be made to sustain and enhance autonomous choice. The concept of conscious consent becomes particularly important. The patient must be made fully aware of the favourable and adverse outcomes of HSCT. Although it is the physician's duty to illustrate the possibility of completely restoring health, considerable emphasis should be put on the adverse effects of the procedure. The physician also needs to decide whether the patient is eligible for HSCT according to the "rule of descending order". The patient must be given full details on self-care and fundamental lifestyle changes and be fully aware that he/she will be partly responsible for the outcome.</p> <p>Summary</p> <p>Only if all the aforesaid conditions are satisfied can it be considered reasonable to propose unrelated HSCT as a potential cure for high risk thalassemia patients.</p

La valutazione ecocolor-Doppler degli assi vascolari mesenterici nell'addome acuto. Studio prospettico su 325 pazienti

La diagnosi di infarto intestinale in un paziente con acuzie addominale è difficile. La sua elevata mortalità è essenzialmente determinata da un ritardo diagnostico e terapeutico. Ciò è dovuto sia ad una scarsa specificità dei dati di laboratorio sia alla scarsità dei segni clinici nelle fasi iniziali della malattia. Obiettivo. Identificare il valore predittivo e negativo della metodica ecocolor-Doppler applicata ai vasi mesenterici nella diagnosi di ischemia acuta intestinale. Pazienti e metodi. 325 pazienti sono stati prospetticamente analizzati con un ecocolor-Dopper Aloka ssd 1700: 120 con addome acuto (gruppo A); 120 soggetti sani senza preparazione intestinale (gruppo B); 85 pazienti sani con preparazione intestinale (gruppo C). Abbiamo valutato la visualizzazione in B mode, l’estensione del vaso, la captazione del segnale colore ed i velocitogrammi. Risultati. In un campione selezionato di 32 pazienti con alto sospetto clinico di infarto mesenterico abbiamo rilevato 21 veri negativi,3 falsi positivi, 5 veri positivi e tre falsi negativi. Il valore predittivo positivo e negativo sono stati rispettivamente di 0,62 e 0,87. Conclusioni. La metodica ecocolor-Doppler si è dimostrata più efficace nell’escludere la presenza di una ischemia intestinale piuttosto che nel confermarla quando presente

Isolated jejunal perforation after blunt trauma. Report of three cases

La perforazione isolata del digiuno ricorre, come complicazione di un trauma chiuso dell’addome, nel 5% dei casi. I tipici segni, quali aria libera nelle immagini radiografiche o peritonismo alla valutazione clinica, impiegano mediamente 12-24 ore a manifestarsi. Presentiamo 3 casi di perforazione isolata del digiuno dopo trauma chiuso dell’addome, di cui uno soltanto diastasico. La TC dell’addome è stata risolutiva nell’identificazione della condizione. I due segni tipici sono stati l’aria libera, anche se modesta in tutti e tre i casi, e il marcato ispessimento di alcune anse digiunali con “enhancement” positiv

Effectiveness of a Modified Administration Protocol for the Medical Treatment of Feline Pyometra

Simple Summary Pyometra is a common reproductive disorder traditionally managed by ovariohysterectomy, although in selected cases (such as breeding subjects or patients with anesthesiologic risk) medical treatment is preferable. This paper aimed to describe the effectiveness of a modified aglepristone administration protocol. Five intact queens were referred for pyometra and were treated with 15 mg/kg of aglepristone on Day 0 (D0), D2, D5, and D8, along with antibiotic treatment (marbofloxacine, 3 mg/kg). Regular ultrasonographic exams confirmed the complete resolution of the infection. After treatment, 3 out of 4 mated cats had an uneventful pregnancy. The results obtained, although limited to a small group, are promising. Further studies are planned to verify its effectiveness in the long-term prevention of recurrence. Pyometra is a common uterine disease of dogs and cats, typical of the luteal phase. Traditionally, ovariohysterectomy was considered the elective treatment for pyometra, but in some cases, such as breeding subjects or patients with a high anesthesiologic risk, medical treatment is preferred. Aglepristone is a progesterone receptor blocker and its use proved to be effective for the medical treatment of pyometra in bitches and queens. The aim of this work is to report the effectiveness, in the feline species, of a modified aglepristone administration protocol. Five intact queens were referred to veterinary care centers for pyometra. Aglepristone (15 mg/kg) was administered at D0, D2, D5, and D8, as described by Contri and collaborators for dogs. An antibiotic treatment (marbofloxacin, 3 mg/kg) was associated, and uterine conditions were checked with regular ultrasonographic exams. The uterus returned to its normal condition 10 days after starting the treatment and no adverse effects were reported. After treatment, three queens had an uneventful pregnancy. Even if the treated group was restricted and homogeneous, the proposed modified protocol proved to be useful and promising for the medical treatment of pyometra in cats; further studies are planned to verify its effectiveness in the long-term prevention of recurrence

Treatment of a Recurrent Pyometra by Surgical Uterine Drainage in a Main Coon Cat

Pyometra is a uterine disease typical of the luteal phase of the estrus cycle. For selected patients, such as breeding subjects, ovariohysterectomy is not a valid resolutive option. Medical treatments involving cloprostenol and aglepristone have been developed for the cats, but they can be ineffective in rare cases. Transcervical drainage and flushing have been described for the dogs, as well as for large wild cats. However, to the author’s knowledge, there are no report of uterine drainage in cats. The present case describes an alternative treatment of pyometra in a 3-year-old Main Coon previously treated with aglepristone. The patient underwent a laparotomy: the uterus was exposed, and a sterile urinary catheter was inserted into each horn, through the wall of the uterus, to allow the drainage of pathological collection and a subsequent lavage with lukewarm sterile saline. Medical treatment with aglepristone and marbofloxacin was associated. After treatment, no recurrence was reported, and the cat had an uneventful pregnancy. Although it is a unique case report, the results presented are promising, as the technique appears to have provided healing and preserved fertility. Further studies are needed to confirm its efficacy in the long-term prevention of recurrence

Treatment of a Recurrent Pyometra by Surgical Uterine Drainage in a Main Coon Cat

: Pyometra is a uterine disease typical of the luteal phase of the estrus cycle. For selected patients, such as breeding subjects, ovariohysterectomy is not a valid resolutive option. Medical treatments involving cloprostenol and aglepristone have been developed for the cats, but they can be ineffective in rare cases. Transcervical drainage and flushing have been described for the dogs, as well as for large wild cats. However, to the author's knowledge, there are no report of uterine drainage in cats. The present case describes an alternative treatment of pyometra in a 3-year-old Main Coon previously treated with aglepristone. The patient underwent a laparotomy: the uterus was exposed, and a sterile urinary catheter was inserted into each horn, through the wall of the uterus, to allow the drainage of pathological collection and a subsequent lavage with lukewarm sterile saline. Medical treatment with aglepristone and marbofloxacin was associated. After treatment, no recurrence was reported, and the cat had an uneventful pregnancy. Although it is a unique case report, the results presented are promising, as the technique appears to have provided healing and preserved fertility. Further studies are needed to confirm its efficacy in the long-term prevention of recurrence