Trends of influenza B during the 2010–2016 seasons in 2 regions of north and south Italy: The impact of the vaccine mismatch on influenza immunisation strategy

Influenza A and B viruses are responsible for respiratory infections, representing globally seasonal threats to human health. The 2 viral types often co-circulate and influenza B plays an important role in the spread of infection. A 6-year retrospective surveillance study was conducted between 2010 and 2016 in 2 large administrative regions of Italy, located in the north (Liguria) and in the south (Sicily) of the country, to describe the burden and epidemiology of both B/Victoria and B/Yamagata lineages in different healthcare settings. Influenza B viruses were detected in 5 of 6 seasonal outbreaks, exceeding influenza A during the season 2012–2013. Most of influenza B infections were found in children aged ≤ 14 y and significant differences were observed in the age-groups infected by the different lineages. B/Victoria strains prevailed in younger population than B/Yamagata, but also were more frequently found in the community setting. Conversely, B/Yamagata viruses were prevalent among hospitalized cases suggesting their potential role in the development of more severe disease. The relative proportions of viral lineages varied from year to year, resulting in different lineage-level mismatch for the B component of trivalent influenza vaccine. Our findings confirmed the need for continuous virological surveillance of seasonal epidemics and bring attention to the adoption of universal influenza immunization program in the childhood. The use of tetravalent vaccine formulations may be useful to improve the prevention and control of the influenza burden in general population

Correlation between CD117+ myeloma plasma cells and hematopoietic progenitor cells in different categories of patients

Background: Multiple myeloma (MM) is a neoplastic disorder of plasma cells interesting mainly the elderly. MM remains an incurable disease, mostly because of the strong interplay between clonal plasma cells (cPCs) and bone marrow (BM) microenvironment. Multiparameter flow cytometry (MFC) allows the simultaneous study of the cPC immunophenotype and alterations involving other cells in BM, but rarely these data are interpreted as connected. One exception to this habit are previous studies about relationship between CD117 cPC positivity and hematopoietic progenitor cell (HPC) distribution in newly diagnosed patients. Thus we were interested in verifying the distribution of BM CD34+ HPCs in healthy controls, and monoclonal gammopathy of undetermined significance (MGUS) patients and various categories of responding/relapsing MM subjects divided according to CD117 positivity. Results: Our data completely agree with precedent reports as regards untreated patients. In the group with progression of disease, CD117- patients exhibited a lower CD34 + CD19-/CD34 + CD19+ ratio vs CD117+ subjects. Among CD117- cases, newly diagnosed patients exhibited differences in distribution of HPCs vs responding myeloma subjects and patients with progressive disease. These differences reached statistical significance comparing CD117- newly diagnosed with CD117- responding cases, as reflected by CD34 + CD19-/CD34 + CD19+ ratio. In turn, no differences emerged comparing CD117+ treated and untreated patients. Conclusions: We demonstrate that administration of treatment and depth of reached response/presence of relapse imply a distinct regulation in distribution of CD34+ HPC subsets in CD117- and CD117+ patients. These differences become evident comparing untreated and treated CD117- patients, but they are impossible to detect in CD117+ cases

HPV vaccine hesitancy among parents of female adolescents: a pre-post interventional study

Human papillomavirus (HPV) is the most common sexually transmitted infection in female adolescents. The highest infection rate is found among individuals aged 15-24 years, and the HPV vaccine represents an opportunity to reduce the burden of cervical cancer caused by HPV types 16 and 18. The World Health Organization has defined girls aged 9e13 years as the priority target for HPV vaccination. In Italy, in accordance with international public health guidelines, HPV vaccination wasfree and actively offered to all girls during their 12th year of life (from the completion of 11 years until the age of 12 years) between 2007 and 2008, establishing a target vaccination coverage of 95% within 5 years of the start of the campaign

A traverso la Spagna

Mode of access: Internet

LE VARIANTI DEL GENE CYP2C19 NELLA FARMACO-GENOMICA DEL CLOPIDOGREL

Il clopidogrel per espletare la propria funzione di antiaggregante piastrinica necessita l\u2019intervento di diversi citocromi epatici. Le varianti del gene CYP2C19 sembrano influenzarne sensibilmente l\u2019attivazione e pertanto l\u2019azione farmacologica. Sono stati identificati tre alleli principali. L\u2019allele CYP2C19*1 \ue8 il wild type e codifica per un enzima costituzionalmente attivo. Gli alleli CYP2C9*2 e CYP2C9*3 codificano invece per forme enzimatiche parzialmente funzionanti e sono responsabili sia in eterozigosi che in omozigosi della variazione di attivit\ue0 farmacologica. La valutazione delle varianti \ue8 stata eseguita mediante le metodiche PCR-RFLP e sequenziamento diretto. Abbiamo allestito due reazioni di amplificazione con primers home made specifici per l\u2019esone 4 e per l\u2019esone 5 del gene CYP2C19. La mutazione caratteristica dell\u2019alleleCYP2C19*3 \ue8 una transizione G/A del nucleotide 636 (esone 4) (trp212ter; W212X). La mutazione dell\u2019esone 5, che identifica l\u2019alleleCYP2C19*2, consiste in una transizione G/A nel nucleotide 681; entrambe le mutazioni causano la produzione di un codone di stop prematuro e la sintesi di una proteina tronca. La prevalenza delle varianti geniche CYP2C19 nel campione di popolazione studiato \ue8 pari al 22% circa ed \ue8 sovrapponibile con quella delle altre popolazioni studiate nel nord Itali

Bone marrow B lymphocytes in multiple myeloma and MGUS: Focus on distribution of naïve cells and memory subsets

Multiple myeloma (MM) is caused by proliferation of clonal plasma cells (cPCs) in bone marrow (BM), associated with numerical and functional defects in immune subsets. An impairment of B cell compartment is involved in onset/progression of the disease

The impact of polypharmacy and drug interactions among the elderly population in Western Sicily, Italy

Aim: Primary endpoint was to report polypharmacy distribution in the general population vs 6565 years old people and to examine the frequency of drug\u2013drug interactions (DDIs) in the Health Local Unit of Palermo, Italy, in relationship with patients\u2019 age. Methods: Drug prescription data for the year 2014 were extracted from the database of the Local Health Unit of Palermo Province, Italy. Patients were divided into five age groups (0\u201313, 14\u201364, 65\u201369, 70\u201374, and 6575 year old). The detection of potential DDIs in polypharmacy profiles was performed with NavFarma software (Infologic srl, Padova, Italia), with DDI classification provided by tool Micromedex Drug Reax (Truven Health Analitics, Michigan, USA). Results: We analyzed data of 1,324,641 patients, and 15,801,191 medical prescription were recorded; of these, 11,337,796 regarded chronic conditions. The drug prescriptions reached the highest values in the 65\u201369 and 70\u201374 age groups (p = 0.005 and p = 0.008 vs age 14\u201364 respectively). An overall amount of 6,094,373 DDIs were detected, of which 47,173 were contraindicated. Median number of DDIs was higher in 65\u201369 and 70\u201374 age groups (p = 0.008 and p = 0.012 vs age 14\u201364, respectively). Regarding contraindicated DDIs a significant difference was detected comparing 14\u201364 vs 6565 age groups (p = 0.010 vs 65\u201369 group, p= 0.005 vs 70\u201374 group and 6575 group). Conclusions: Polypharmacy is a phenomenon acquiring increasing dimensions also in our province. It interests particularly the older subjects, and assumes a dramatic accent when it is put in relationship with the frequency of DDIs. A proactive vigilance about potential life threatening drug interactions is mandatory

Determinants of inappropriate hospitalization in cataract surgery in the south of Italy: a retrospective study

Purpose To analyze the frequency of inappropriate hospitalization in cataract surgery and the type of related determinants. Methods A nested retrospective case\u2013control study was carried out on 2708 consecutive cataract surgery patients operated between January 2013 and Decem- ber 2015. All cases with inappropriate hospitalization (day surgery or ordinary hospitalization) were com- pared with a control group of cases treated in an appropriate (day service) regimen. The predictive value for inappropriate admissions to the hospital was assessed using a logistic regression model. Significant variables from the univariate analysis were included in a multivariate model. Results Forty-five cases (\ 2%) of inappropriate hospital admissions were recorded. Residence, heart disease, tremors, anticoagulants, intraoperative floppy iris syndrome were not related to appropriateness, while psychotic disorder (OR 12.571, p = 0.018), anxiety-depressive syndrome (OR 7.818, p = 0.010) and use of antipsychotropic drugs (OR 7.724, p = 0.002) were related to the inappropriateness of admission by univariate and multivariate analysis. Previous systemic surgeries were predictors of ordi- nary hospitalization by logistic regression analysis. A greater presence of hypertension, diabetes mellitus and fellow eye pseudophakia was noticed in appro- priate hospitalization cases. Conclusions This study detects the predictive role of psychiatric disorders as determinants of hospitaliza- tion inappropriateness in cataract surgery. The nega- tive correlation between inappropriate hospitalization and conditions such as hypertension and diabetes points out that in the elderly population common diseases are effectively addressed, in contrast to the difficult management of psychiatric patients. Prior systemic interventions represent factors inducing transfer from day service to ordinary hospitalization, highlighting communication problems related to dif- ficult coping with an outpatient surgery setting