Prenatal diagnosis of a rare form of congenital mid-ureteral stricture: a case report and literature revisited

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Ceftazidime/avibactam resistance is associated with different mechanisms in KPC-producing Klebsiella pneumoniae strains

This study focused on Klebsiella pneumoniae isolates that were resistant or had low susceptibility to a combination of ceftazidime/avibactam. We aimed to investigate the mechanisms underlying this resistance. A total of 24 multi-drug resistant isolates of K. pneumoniae were included in the study. The phenotypic determination of carbapenemase presence was based on the CARBA NP test. NG-Test CARBA 5 was also performed, and it showed KPC production in 22 out 24 strains. The molecular characterisation of blaKPC carbapenemase gene, ESBL genes (blaCTX-M, blaTEM, and blaSHV) and porin genes ompK35/36 was performed using the PCR. Finally, ILLUMINA sequencing was performed to determine the presence of genetic mutations.Various types of mutations in the KPC sequence, leading to ceftazidime/avibactam resistance, were detected in the analysed resistant strains. We observed that KPC-31 harboured the D179Y mutation, the deletion of the amino acids 167-168, and the mutation of T243M associated with ceftazidime/avibactam resistance. The isolates that did not present carbapenemase alterations were found to have other mechanisms such as mutations in the porins. The mutations both on the KPC-3 enzyme and in the porins confirmed, that diverse mechanisms confer resistance to ceftazidime/avibactam in K. pneumoniae

Paediatric unilateral giant hydroureteronephrosis from idiopathic ureterovesical stricture: a case report

A congenital type of ureterovesical junction obstruction may be present in the fetus or at any stage during childhood, more commonly associated with urinary tract infections and other secondary causes. We present the case of a 6-year-old boy who suffered from colic and side pain, which was worsening monthly. He suffered from a giant hydroureteronephrosis resulting from idiopathic ureterovesical junction obstruction, with no clinical or laboratory signs of urinary tract infection or other secondary causes of obstruction. Indications for surgery were a decrease in kidney function (<40%) at scintigraphy, severe hydronephrosis (>30 mm), and the coexistence of symptoms (colic pain). After surgery, kidney function returned to almost completely normal. Unexpectedly an obstruction may become symptomatic late in infancy, especially in patients with normal prenatal ultrasound screening and postnatal life, as was the case for our patient in whom the only clinical sign was pain at flank

Microglena antarctica sp. nov. a New Antarctic Green Alga from Inexpressible Island (Terra Nova Bay, Ross Sea) Revealed through an Integrative Approach

One of the aims of the XXXIV Italian Antarctic Expedition is the study of the photosynthetic biodiversity of the Ross Sea. To achieve this goal, sea-ice samples were collected from Inexpressible Island and a strain of a green microalga (IMA076A) was isolated for morphological and molecular investigations. Combining: (1) phylogenetic analyses of the small subunit rDNA (18S rDNA) and of the internal transcribed spacer 2 (ITS-2) sequences; (2) species delimitation methods; (3) comparative analyses of the secondary structures of ITS-2 and compensatory base changes; (4) morphological, ultrastructural and ecological features, we described the strain IMA076A and its relatives as the new species Microglena antarctica sp. nov. The discovery of a new species of Chlorophyceae highlights that the biological diversity of Antarctic microalgae is more extensive than previously thought and that molecular phylogeny together with compensatory base changes (CBCs) approach are pivotal in the identification of cryptic microalgae

<i>Microglena antarctica</i> sp. nov. a New Antarctic Green Alga from Inexpressible Island (Terra Nova Bay, Ross Sea) Revealed through an Integrative Approach

One of the aims of the XXXIV Italian Antarctic Expedition is the study of the photosynthetic biodiversity of the Ross Sea. To achieve this goal, sea-ice samples were collected from Inexpressible Island and a strain of a green microalga (IMA076A) was isolated for morphological and molecular investigations. Combining: (1) phylogenetic analyses of the small subunit rDNA (18S rDNA) and of the internal transcribed spacer 2 (ITS-2) sequences; (2) species delimitation methods; (3) comparative analyses of the secondary structures of ITS-2 and compensatory base changes; (4) morphological, ultrastructural and ecological features, we described the strain IMA076A and its relatives as the new species Microglena antarctica sp. nov. The discovery of a new species of Chlorophyceae highlights that the biological diversity of Antarctic microalgae is more extensive than previously thought and that molecular phylogeny together with compensatory base changes (CBCs) approach are pivotal in the identification of cryptic microalgae

Vector-Transmitted Flaviviruses: An Antiviral Molecules Overview

: Flaviviruses cause numerous pathologies in humans across a broad clinical spectrum with potentially severe clinical manifestations, including hemorrhagic and neurological disorders. Among human flaviviruses, some viral proteins show high conservation and are good candidates as targets for drug design. From an epidemiological point of view, flaviviruses cause more than 400 million cases of infection worldwide each year. In particular, the Yellow Fever, dengue, West Nile, and Zika viruses have high morbidity and mortality-about an estimated 20,000 deaths per year. As they depend on human vectors, they have expanded their geographical range in recent years due to altered climatic and social conditions. Despite these epidemiological and clinical premises, there are limited antiviral treatments for these infections. In this review, we describe the major compounds that are currently under evaluation for the treatment of flavivirus infections and the challenges faced during clinical trials, outlining their mechanisms of action in order to present an overview of ongoing studies. According to our review, the absence of approved antivirals for flaviviruses led to in vitro and in vivo experiments aimed at identifying compounds that can interfere with one or more viral cycle steps. Still, the currently unavailability of approved antivirals poses a significant public health issue

Different OXA-Carbapenemases in Genetically Unrelated Klebsiella pneumoniae Strains Isolated in a North Italian Hospital During Multidrug Resistance Screening

: Klebsiella pneumoniae is one of the main opportunistic pathogens that cause a broad spectrum of diseases with increasingly frequent acquisition of resistance to antibiotics, namely carbapenems. This study focused on the characterization of 23 OXA-48-like carbapenemase-producing K. pneumoniae isolates using phenotypic and molecular tests. Phenotypic determination of the presence of β-lactamases was performed using the extended-spectrum beta-lactamase (ESBL) NP test, and phenotypic determination of the presence of carbapenemase was based on the Carba NP test. Antimicrobial susceptibility tests were performed to assess the resistance against carbapenems. Molecular characterization of ESBL genes and carbapenemase genes (blaOXA-48, blaKPC, blaVIM, and blaNDM) was performed using polymerase chain reaction (PCR) techniques. In addition, K. pneumoniae strains were analyzed for their relatedness using multilocus sequence typing PCR analysis based on the Institut Pasteur protocol, which produces allelic profiles that contain their evolutionary and geographic pattern. Following further Sanger sequencing of the blaOXA-48 genes, no genetic mutations were found. Some OXA-48-producing K. pneumoniae isolates coharbored blaKPC, blaNDM, and blaVIM genes, which encode other carbapenemases that can hydrolyze carbapenem antibiotics. The final part of the study focused on the characterization of the plasmid profiles of all isolates to better understand the spreading of the IncL/M blaOXA-48 plasmid gene. The plasmid profile also revealed other incompatibility groups, suggesting that other plasmid genes are spreading in K. pneumoniae isolates, which can coharbor and spread different carbapenemases simultaneously

Surgical management of follicular thyroid carcinoma in children and adolescents: A study of 30 cases

Background/Purpose: The purpose of the study is to describe the anatomoclinical, diagnostic, therapeutic and prognostic aspects of pediatric follicular thyroid carcinoma (FTC) in order to choose the best therapeutic strategy. Methods: Our study includes patients ≤ 18 years old surgically treated for FTC in four Italian Pediatric Surgery Centers from January 2000 to March 2017. The collected data were compared with those of 132 patients matched for age with a histological diagnosis of papillary thyroid carcinoma (PTC) surgically treated in the same institutions during the same period and with the data of patients diagnosed with FTC found in the literature; p-values 4 cm, especially with high after-surgery Tg rate, a completion of thyroidectomy is recommended. In patients with multifocal neoplasia, and/or tumor size ≥ 4 cm, and/or extrathyroid extension, and/or lymph node metastasis, and/or distant metastasis, total thyroidectomy followed by radioiodine therapy is generally indicated. Levels of Evidence: II

Sentinel Node Biopsy in Pediatric Soft Tissue Sarcomas of Extremities

BACKGROUND: Sentinel Node Biopsy is an established staging technique in many adult malignancies. However, only few reports describe this procedure for the evaluation of regional lymph nodes in childhood and adolescents. Our experience with sentinel node biopsy in soft tissue sarcomas of extremities in children is reported. METHODS: Seventeen children were evaluated with sentinel node biopsy between 2002 and 2007: 11 at initial surgery, 5 at primary re-excision, 1 at local relapse. The diagnosis was rhabdomyosarcoma in 5 and other soft tissue sarcomas in 12: Ewing/PNET sarcoma 6, epithelioid sarcoma 1, malignant peripheral-nerve-sheath tumor 1, undifferentiated sarcoma 1, myxoid liposarcoma 2, adult-type fibrosarcoma 1. Primary sites included lower limbs (8), upper limbs (9). Mapping of nodes was performed with lymphoscintigraphy plus intra-operative injections with blue-dye in 14 cases, with lymphoscintigraphy and intra-operative injections alone in 2 and 1, respectively. RESULTS: Of the 17 lymphatic regions (9 axilla, 8 inguinal), 16 were identified with lymphoscintigraphy, 15 by intra-operative injections. Thirty-five lymph nodes were removed. Nodes were positive for metastasis in two patients with alveolar rhabdomyosarcoma and undifferentiated sarcoma. There were no complications. No further lymph node metastases were recognized either at diagnosis or during the follow-up (6-78 months). CONCLUSIONS: Sentinel node biopsy was technically feasible, reliable, and free of complications. It could be an alternative to aggressive or random biopsies for extremity rhabdomyosarcoma and it can contribute to define those non-rhabdomyosarcoma soft tissue sarcomas that spread to regional nodes