Prevalence and antifungal susceptibility patternsof yeasts from women with vulvovaginitis

none10F. Zara; R. E. Nappi; R. Brerra; R. Mighavacca; E. Nucleo; M. Spalla; C. Bergante; A. Smeraldi; L. Pagani; A. SpinilloZara, Francesca; Nappi, R. E.; Brerra, Roberto; Migliavacca, Roberta; Nucleo, Elisabetta; Spalla, Melissa; Bergante, C.; Smeraldi, A.; Pagani, Laura; Spinillo, Arseni

Platelet size distinguishes between inherited macrothrombocytopenias and immune thrombocytopenia.

Distinguishing inherited thrombocytopenias from immune thrombocytopenia (ITP) can be difficult, and patients are therefore at risk of misdiagnosis and inappropriate treatments. Although it is known that the most common inherited forms of thrombocytopenia are characterized by increased platelet size, the diagnostic power of this feature has never been investigated. OBJECTIVES: The aim of this study was to test the hypothesis that platelet size can be used to differentiate ITP from inherited macrothrombocytopenias. Patients/methods: We measured mean platelet volume (MPV) and mean platelet diameter (MPD), within 2 h of blood sampling, in 35 patients with inherited macrothrombocytopenias [15 MYH9-related disease (MYH9-RD), three biallelic and 17 monoallelic Bernard-Soulier syndrome (BSS)], and 56 with ITP. Using receiving operating characteristic analysis, we searched for the best cut-off values to differentiate between these conditions. RESULTS: As expected, platelets were larger in inherited macrothrombocytopenias than in ITP. An MPD larger than 3.3 mum differentiated MYH9-RD and BSS from ITP with 0.89 sensitivity and 0.88 specificity, and an MPV larger than 12.4 fL had 0.83 sensitivity and 0.89 specificity. Combining MPD with MPV increased sensitivity and specificity to 0.97 and 0.89, respectively. CONCLUSION: Platelet size evaluation by both an appropriate cell counter and blood film examination is useful for differentiating inherited macrothrombocytopenias from ITP

Two-year prospective study of single infections and co-infections by respiratory syncytial virus and viruses identified recently in infants with acute respiratory disease.

A prospective 2-year analysis including 322 infant patients with acute respiratory disease (ARD) hospitalized in a pediatric department in northern Italy was carried out to evaluate the role as respiratory pathogens or co-pathogens of recently identified viruses. The presence of respiratory syncitial virus (RSV), human Metapneumoviruses (hMPVs), human Bocaviruses (hBoVs), and human Coronaviruses (hCoVs) was assayed by molecular detection and clinical symptoms evaluated. Nasopharyngeal aspirates from 150 of the 322 infants (46.6\%) tested positive for at least one pathogen. Ninety samples (28.0\%) tested positive for RSV RNA (61.5\% genotype A and 38.5\% genotype B), 46 (14.3\%) for hMPV RNA (71.7\% subtype A and 28.3\% subtype B), 28 (8.7\%) for hCoV RNA (39.3\% hCoV-OC43, 35.7\% hCoV-NL63, 21.4\% hCoV-HKU1, and 3.6\% hCoV-229E), and 7 (2.2\%) for hBoV DNA (of the 6 typed, 50\% subtype 1 and 50\% subtype 2); 21/150 samples revealed the presence of 2 or more viruses. Co-infection rates were higher for hMPVs, hCoVs, and hBoV (38.3\%, 46.4\%, and 57.1\%,) and lower for RSV (23.3\%). RSV was associated with the presence of complications (P < 0.001) and hypoxia (P < 0.015). When the presence of RSV alone and the RSV-hMPV co-infections were considered, RSV mono-infected patients resulted to have longer hospitalization and higher hypoxia (P < 0.001). The data highlight that (i) RSV has a central role as a respiratory pathogen of infants, (ii) the wide circulation of recently identified viruses does not reduce the clinical and epidemiological importance of RSV, and that (iii) recently identified agents (hMPVs, hBoVs, and hCoVs) act as primary pathogens or co-pathogens