QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study

Background: healthcare workers (HCWs) are at higher risk of being exposed to tuberculosis (TB). The aim of this study was to estimate LTBI prevalence and evaluate associated risk factors among Italian HCWs using a new generation IGRA test, Quantiferon Plus (QTF-Plus), providing also an analytical evaluation of this test. Methods: this cross-sectional study was conducted during the annual health surveillance program performed in 2017, evaluating 1470 HCWs of a teaching hospital in Rome, tested with QTF-Plus. A standardized questionnaire was collected for multivariate risk analysis. The independent variables associated with a higher frequency of LTBI were tested in a multivariate logistic regression model. Results: LTBI was diagnosed in 50 out of 1470 (3.4%) of HCWs. The male gender and age>40 years were significantly associated with the risk of LTBI. The levels of interferon-γ were significantly lower in subjects with a recent conversion than in those with an older positivity. Moreover, interferon-γ values exceeding 8 IU/ml were recorded in 8 out of 35 remote subjects but in no recent subjects. The concordance between TB1 and TB2 results was 88%, while in 6 out of 50 subjects we found a discrepancy. Conclusion: the LTBI condition among Italian HCWs was very low. In subjects with discordant outcomes between TB1 and TB2, especially when the test values are close to the cut-off, is recommended a repetition of the test to confirm its positivity. Key words: tuberculosis, latent tuberculosis infection, interferon-gamma release assay, quantiferon plus, healthcare worker

AFLP variability, toxin production, and pathogenicity of Alternaria species from Argentinean tomato fruits and puree

Large amounts of tomato fruits and derived products are produced in Argentina and may be contaminated by Alternaria toxins. Limited information is available on the genetic variability, toxigenicity, and pathogenicity of Alternaria strains occurring on tomato. We analyzed 65 Alternaria strains isolated in Argentina from tomato fruits affected by black mould and from tomato puree, using amplified fragment length polymorphisms (AFLPs) technique. AFLP analysis resolved the set of strains in 3 main clusters (DICE similarity values of 58 and 60%) corresponding to A. alternata/tenuissima (44 strains), A. arborescens (15 strains) and to an unknown group (6 strains). Most of the representative strains, belonging to each AFLP cluster, when cultured on rice, produced tenuazonic acid (up to 46,760. mg/kg), alternariol monomethyl ether (AME, up to 1860. mg/kg), and alternariol (up to 70. mg/kg). The toxin profile related to the strains was not related to any AFLP cluster, except for AME which was produced at lower level by A. arborescens. Most of strains were pathogenic on two types of commonly cultivated tomato fruits. These findings provide new information on the variability within the Alternaria species complex associated with tomato disease.Fil: Somma, Stefania. Institute of Sciences of Food Production; ItaliaFil: Pose, Graciela Noemi. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pardo, Alejandro Guillermo. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Mulè, Giuseppina. Institute of Sciences of Food Production; ItaliaFil: Fernández Pinto, Virginia Elena. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Orgánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Moretti, Antonio. Institute of Sciences of Food Production; ItaliaFil: Logrieco, Antonio Francesco. Institute of Sciences of Food Production; Itali

The frameshift Leu220Phefs*2 variant in KRIT1 accounts for early acute bleeding in patients affected by cerebral cavernous malformation

Abstract Background and Objectives Cerebral cavernous malformation (CCM) is a neurovascular disease characterized by abnormally expanded and tortuous microvessels with increased predisposition to thrombosis and focal hemorrhage. Its incidence is estimated to range between 0.4% and 0.8%. Sporadic and familial forms of CCM are described. The first one is characterized by single lesion, while the familial form is defined by multiple malformations. In this scenario, more than 300 mutations affecting the CCM genes have been described to date, but the exact pathogenic mechanism is yet unknown. Most of the causative variants of KRIT1 gene are frameshift but there are many missense and nonsense variants and they have been found some splicing mutations. The diagnosis is based on magnetic resonance images (MRI) and genetic testing. Case report A 15-year-old male presented with a two weeks duration worsening headache accompanied by vomiting and three months behavioral changes. Computer tomography revealed a large right temporal lesion with other smaller in left parietal and left cerebellar region. At the time of diagnosis, the two siblings of the proband were asymptomatic. Nevertheless, four months later, the 7-years-old brother was admitted to the emergency room for balance deficit, diplopia, right-hitting nystagmus and stiff neck with deviation of the head. A cerebral CT revealed polylobate hyperdense mass of the middle cerebral pedicle associated to acute bleeding. A genetic testing for hereditary cavernous brain malformation was carried out. Results The molecular analysis identified a 2-bp duplication (NM_194456.1:c.658_659dupTT) as heterozygous within the exon 8 of CCM1/KRIT1 gene (Fig. 1C). This duplication leads to a frameshift variant, resulting in a premature stop codon (p.Leu220Phefs*2). Discussion The clinical data collected confirm the variable phenotypic expression of CCM and suggest a greater severity of symptoms in the youngest patients

Prevalence and characteristics of functional dyspepsia among workers exposed to cement dust.

No data are currently available on the prevalence and characteristics of functional dyspepsia among cement workers. Given the potential impact of dyspepsia on work performance, whether its prevalence is increased among workers exposed to cement dust was evaluated

Are thyroid dysfunctions related to stress or microwave exposure (900 MHz)?

In the last decade, numerous scientific evidence suggested possible adverse health effects from exposure to electromagnetic fields (EMF'S) and the use of mobile phones. According to some studies EMF induced changes of trans-membrane Ca++ flux may lead to altered metabolism and/or secretion of neurohormones including TSH, ACTH, GH, prolactin and melatonin. The aim of this research was to analyse the effects of mobile phone use on thyroid function and to evaluate the possible role of occupational stress. 2598 employees (1355 men and 1243 women) with different duties (vendors, operators and network technicians) were included in the study. Exposure to EMF'S, generated by mobile phones, was assessed both by submitting a questionnaire directly to the employees and acquiring data regarding conversation times. The workers were divided into three groups on the basis of their personal mobile phone use. Moreover, a group of 160 workers with TSH values below 0.4 UI/l was characterized. No statistically significant difference regarding TSH values below 0.4 UI/l was observed among workers with different duties but there was a greater prevalence of subjects with low SH values among 192 employees with more than 33 hrs./month conversation time; this difference was statistically significant (p<0.05). On the basis of our data, it is not possible to establish whether this result is determined by exposure to EMF'S from mobile phones of by the stress of using these instruments

Global Policy to Reduce the Incidence of Infection Spreading in Non-Vaccinated Healthcare Workers: A Literature Review

Healthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection because of their occupational exposure. Moreover, they can be a vehicle for the virus transmission among patients. The vaccination of healthcare personnel against COVID-19 is crucial in fighting the spread of SARS-CoV-2 infection, together with strict sanitary procedures that aim to limit the risk of contagion. Unfortunately, even if COVID-19 vaccination has been proved one of the most effective tools for protecting against COVID-19, many healthcare professionals are not yet vaccinated. The aim of the current review is to contribute to identifying an effective strategy for COVID-19 prevention especially among non-vaccinated HCWs. In this review, we collected the most recent and relevant findings from literature on the protection of unvaccinated HCWs, identifying three types of measures as principal actions to protect those operators: addressing vaccine hesitancy, improving non-pharmaceutical interventions and promoting actions at personal level (respiratory hygiene, hand hygiene and use of PPE). All these interventions are very effective in preventing contagion, if well respected and conducted; nevertheless, it is essential to promote vaccination, as it is the most effective measure