Italian Physicians' Opinions on Rotavirus Vaccine Implementation

Rotavirus (RV) infection is the main cause of severe acute gastroenteritis (GE) in the pediatric population and has a major impact in both developing and industrialized countries. The reduction of severe RVGE cases, followed by death or hospitalization, is considered the main benefit of RV vaccination, even though its implementation often faces obstacles. In Italy, the recently approved National Immunization Plan aims to overcome the differences among regions, offering a universal free RV vaccination. The aim of the study was to evaluate the opinions on benefit and acceptability of RV vaccination related to the perception of the burden of RV disease. Data were collected from 108 physicians in 2015 by a questionnaire consisting of 12 questions; some answers were compared with those obtained with a similar tool in 2011. The majority of respondents (76.2%) was convinced of the benefit of the vaccine and 57.4% recommended it routinely, but more than half indicated a <25% adherence to RV vaccination among their patients. As the main reasons of vaccine refusal, skepticism about the vaccine (60.4%) and its cost (34.1%) were indicated. Our data confirm that more information and counselling are needed to increase RV vaccine coverage

Healthcare workers training courses on vaccinations: A flexible format easily adaptable to different healthcare settings.

Since 2017, Italy has expanded the compulsory vaccination from 4 to 10 for those aged 0 to 16 years. Because of the great organizational effort required for the immunization services, minor attention was given to the vaccinations not included among the mandatory ones. This situation led to a real difficulty in harmonizing the vaccination procedures even inside a single region. In the Lazio region, the Laboratory of Vaccinology of the University of Rome Tor Vergata established a working group to create a new training model for healthcare professionals. The course program proposed an update of three vaccinations which are not mandatory but actively offered. It included the same part of scientific updating and a variable part based on local experiences. A specific anonymous questionnaire on knowledge and attitude was administered. The study aimed to propose a general format of training courses for vaccination centers adaptable to the individual local health units (ASLs) and to evaluate through questionnaires. The results show differences in knowledge and attitudes toward non‐mandatory vaccinations among the ASLs of Lazio, confirming the usefulness of a support to make knowledge and procedures homogeneous. This model could be adapted to any healthcare setting and exported to other services

The role of the Bcl-2 family of proteins in the pathogenesis of B-cell chronic lymphocytic leukaemia

B-cell chronic lymphocytic leukaemia (B-CLL) is an acquired neoplastic disease characterised by a clonal accumulation of long-lived, functionally immature and CD5+ B-lymphocytes, which particularly accumulate in the lymphatic system, peripheral blood, bone marrow, spleen and liver. Symptoms include lymphocytosis, immune system dysfunction and autoimmune disease, but transformation to more aggressive forms of neoplastic disease occur and development of a second malignancy is not uncommon. The disease is one of later years being unusual before 50 years of age, the rates of incidence vary on a racial basis, and it has a highly variable prognosis. Some patients die within months of diagnosis despite intensive treatment, whilst others survive for 30-plus years without any form of medical intervention and die of unrelated causes. The principal causes of death in patients whose deaths are directly related to the disease are opportunistic infection due to the impairment of immune system function and bleeding disorders. No treatment has been shown to cure the disease or consistently extend life expectancy. It has been recognised for more than 30 years that the accumulation of malignant cells in B-CLL is at least as important in the pathogenesis of the disease as their neoplastic proliferation. With the discoveries that Bcl-2 extended the life of follicular lymphoma cells by conferring resistance to apoptosis and was commonly expressed in B-CLL cells, it was extrapolated that Bcl-2 might play a similar role in the development of the disease by extending the life span of B-CLL cells. Bcl-2 has frequently been shown to be over expressed in B-CLL cells and genetic translocations and/or malfunction of Bcl-2 family regulating molecular entities may play a part in this. However, since its discovery, Bcl-2 has been shown to be part of a large family of genes which is highly and evolutionarily conserved. Members of the bcl-2 family are defined by sequence homology in four Bcl-2 homology (BH) regions and a hydrophobic membrane-spanning domain, with the possession of specific BH domains determining whether individual proteins have pro- or anti-apoptotic activity. Family members such as Bcl-2 and Bcl-XL extend the life span of cells, whilst others such as Bax and Bak shorten it. Oltvai, Milliman and Korsmeyer have proposed a general model of apoptosis, in which the cell's apoptotic fate is determined by the cellular balance between pro- and anti-apoptotic bcl-2 family members. The effect of unregulated expression of Bcl-2 family members in B-CLL cells conforms to this paradigm and resistance to apoptosis appears to be conferred through a cellular imbalance of power between pro- and anti-apoptotic bcl-2 family members, particularly Bcl-2 and Bax, which is tilted in favour of cell survival. However, the apoptotic fate of B-CLL cells, and hence the neoplasm, may be influenced by other family members, with Mcl-1, Bcl-XL, Bak, with the non-family but Bcl-2-associated protein, Bag-1, also found expressed in B-CLL cells. Similarities between the structure of the more conserved family members and other pore-forming proteins, along with the ability of Bcl-2, Bcl-XL, and Bax to form pores in synthetic membranes, suggest that they may exert their influence through pore-forming activities in intracellular membranes, particularly mitochondrial membranes. Bcl-2 family members may regulate apoptosis by changing the permeability of membranes to ions and apoptosis-inducing molecules, and physical interactions between Bcl-2 family proteins mediated by the BH domains may be important in both pore-forming and pore-inhibiting activities. Research findings suggest that the levels of Bcl-2 family members in B-CLL cells may be modulated by a wide range of largely extracellular influences, including the cytokines interleukin-4 (IL-4), IL-8, IL-10, interferon-a (IFN-?), IFN-?, and basic fibroblast growth factor (bPGF). Levels of Bcl-2 family members may also be modulated by contact between B-CLL cells and bone marrow (BM) stromal cells, activation of lgM, CD95, CD40 or CD6, the p53 gene product, and co-cultivation with CDw32-transfected murine fibroblasts. Such modulation may offer some insight into the pathogenesis of the disease, an explanation for the higher level expression of Bcl-2 family members in B-CLL, and an explanation for the highly variable prognosis. Additionally, if Bcl-2 family members can be shown unequivocally to be controlled by any of these molecular entities, the existence of these influences may offer the opportunity to reduce the neoplastic cells' apoptotic threshold by manipulating the relative levels of pro- and anti-apoptotic Bcl-2 family members as a treatment regime, or prior to more conventional treatment regimes

LALINET: The First Latin American–Born Regional Atmospheric Observational Network

Sustained and coordinated efforts of lidar teams in Latin America at the beginning of the 21st century have built LALINET (Latin American Lidar NETwork), the only observational network in Latin America created by the agreement and commitment of Latin American scientists. They worked with limited funding but an abundance of enthusiasm and commitment toward their joint goal. Before LALINET, there were a few pioneering lidar stations operating in Latin America, described briefly here. Bi-annual Latin American Lidar Workshops, held from 2001 to the present, supported both the development of the regional lidar community and LALINET. At those meetings, lidar researchers from Latin America meet to conduct regular scientific and technical exchanges among themselves and with experts from the rest of the world. Regional and international scientific cooperation has played an important role for the development of both the individual teams and the network. The current LALINET status and activities are described, emphasizing the processes of standardization of the measurements, methodologies, calibration protocols, and retrieval algorithms. Failures and successes achieved in the buildup of LALINET are presented. In addition, the first LALINET joint measurement campaign and a set of aerosol extinction profile measurements obtained from the aerosol plume produced by the Calbuco volcano eruption on April 22, 2015, are described and discussed.Fil: Antuña Marrero, Juan Carlos. Centro Meteorológico de Camagüey; CubaFil: Landulfo, Eduardo. Instituto de Pesquisas Energéticas e Nucleares; BrasilFil: Estevan, René. Centro Meteorológico de Camagüey; CubaFil: Barja, Boris. Centro Meteorológico de Camagüey; Cuba. Universidade de Sao Paulo; BrasilFil: Robock, Alan. State University of New Jersey; Estados UnidosFil: Wolfram, Elian Augusto. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones Científicas y Técnicas para la Defensa. Centro de Investigación en Láseres y Aplicaciones; ArgentinaFil: Ristori, Pablo Roberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones Científicas y Técnicas para la Defensa. Centro de Investigación en Láseres y Aplicaciones; ArgentinaFil: Clemesha, Barclay. Upper Atmosphere Research Group; BrasilFil: Zaratti, Francesco. Universidad Mayor de San Andrés; BoliviaFil: Forno, Ricardo. Universidad Mayor de San Andrés; BoliviaFil: Armandillo, Errico. ESTEC; Países BajosFil: Bastidas, Álvaro E.. Universidad Nacional de Colombia. Sede Medellin; ColombiaFil: de Frutos Baraja, Ángel Máximo. Universidad de Valladolid; EspañaFil: Whiteman, David N.. National Aeronautics and Space Administration; Estados UnidosFil: Quel, Eduardo Jaime. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones Científicas y Técnicas para la Defensa. Centro de Investigación en Láseres y Aplicaciones; ArgentinaFil: Barbosa, Henrique M. J.. Universidade de Sao Paulo; BrasilFil: Lopes, Fabio. Comissao Nacional de Energia Nuclear. Centro de Lasers e Aplicacoes. Instituto de Pesquisas Energeticas e Nucleares.; BrasilFil: Montilla-Rosero, Elena. Universidad de Concepción; Chile. Universidad Escuela de Administración, Finanzas e Instituto Tecnológico; ColombiaFil: Guerrero Rascado, Juan L.. Comissao Nacional de Energia Nuclear. Centro de Lasers e Aplicacoes. Instituto de Pesquisas Energeticas e Nucleares.; Brasil. Universidad de Granada; Españ

[Neisseria meningitidis: new vaccines and preventive strategies]

Invasive disease caused by Neisseria meningitidis raise concern in the population and Public Health Authority is called to propose and test strategies for optimizing resources available for its prevention. Polysaccharide vaccines started the approach to immune prophylaxis, the introduction of conjugate vaccines brought to major advances for the prevention of this disease and the future availability of a vaccine against serogroup B will provide an additional tool to protect the population

[Combined or coadministred Measles, Mumps, Rubella and Varicella Vaccines? That is the question!]

In November 2011, the Medicine's Italian Agency published the Pediatric Working Group's recommendation; that is do not use the quadruple vaccine against measles, rubella, mumps and varicella as first dosage in children from 12 to 23 months, because it involves an increase of febrile convulsions risks. It caused a big discussion between international and national Scientific and Institutional Bodies. In Italy, varicella is the most common vaccine preventable disease and preventive measures are not uniform. Clear and universally accepted indication is needed

[Combined or coadministred Measles, Mumps, Rubella and Varicella Vaccines? That is the question!]

In November 2011, the Medicine's Italian Agency published the Pediatric Working Group's recommendation; that is do not use the quadruple vaccine against measles, rubella, mumps and varicella as first dosage in children from 12 to 23 months, because it involves an increase of febrile convulsions risks. It caused a big discussion between international and national Scientific and Institutional Bodies. In Italy, varicella is the most common vaccine preventable disease and preventive measures are not uniform. Clear and universally accepted indication is needed

Italian physicians’ opinions on rotavirus vaccine implementation

Rotavirus (RV) infection is the main cause of severe acute gastroenteritis (GE) in the pediatric population and has a major impact in both developing and industrialized countries. The reduction of severe RVGE cases, followed by death or hospitalization, is considered the main benefit of RV vaccination, even though its implementation often faces obstacles. In Italy, the recently approved National Immunization Plan aims to overcome the differences among regions, offering a universal free RV vaccination. The aim of the study was to evaluate the opinions on benefit and acceptability of RV vaccination related to the perception of the burden of RV disease. Data were collected from 108 physicians in 2015 by a questionnaire consisting of 12 questions; some answers were compared with those obtained with a similar tool in 2011. The majority of respondents (76.2%) was convinced of the benefit of the vaccine and 57.4% recommended it routinely, but more than half indicated a &lt;25% adherence to RV vaccination among their patients. As the main reasons of vaccine refusal, skepticism about the vaccine (60.4%) and its cost (34.1%) were indicated. Our data confirm that more information and counselling are needed to increase RV vaccine coverage