Standardization or tailorization of veterinary vaccines: a conscious endeavour against infectious disease of animals.
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Protecting animals from infection is a major obligation of every veterinarian's work in order to preserve animal welfare while assuring human health. Highly infectious animal diseases can reduce the performances of food producing animals and may have a great economical impact on many industries. Some animal diseases can be transmitted to humans, and control of these types of diseases, is beneficial to public health. In the wild, animal populations reduced by disease can dramatically affect the ecological balance of an area. Vaccination is one part of an effective health program as it helps to prevent disease and, in most cases, is more cost-effective than treating sick animals. Veterinarians have succeeded in greatly reducing the incidence of important diseases by taking advantage from improved technologies in vaccines production and by planning vaccination schedules based on the different characteristics of available products. Today, veterinarians can recommend and plan to use vaccines designed for a specific herd or flock or class of animals and even for individual treatments. (+info)
Markers of myeloproliferative diseases in childhood polycythemia vera and essential thrombocythemia.
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PURPOSE: Polycythemia vera (PV) and essential thrombocythemia (ET) can present in pediatric age as sporadic or familial diseases. To define the biologic profile of childhood PV and ET, we evaluated specific markers in a cohort of pediatric patients affected by PV and ET, including cases with familial occurrence. PATIENTS AND METHODS: Thirty-eight children with PV and ET were investigated. The control group included 58 adults with PV and ET. Endogenous erythroid colonies, qualitative reverse transcriptase polymerase chain reaction for polycythemia rubra vera-1 (PRV-1) RNA expression, human androgen receptor assay and allele specific polymerase chain reaction for JAK2 V617F mutation were undertaken in all patients. Thrombopoietin, thrombopoietin receptor (c-mpl), and erythropoietin receptor mutation analysis was performed by direct sequencing in familial cases. RESULTS: The JAK2 V617F mutation in children with PV was significantly less frequent than in adult PV. The most common myeloproliferative marker found in these patients was PRV-1 RNA overexpression. Children and adults with sporadic ET showed a similar proportion of patients with PRV-1 RNA overexpression, JAK2 V617F mutation, and clonality, while none of the familial ET showed JAK2 V617F mutation and clonality. Also, PRV-1 RNA overexpression was significantly less common. Furthermore, most patients with familial ET exhibited the dominant-positive activating mutation of c-mpl. Finally, children with PV and ET had a significant lower incidence of thrombosis than adults. CONCLUSION: This study demonstrates that familial and sporadic ET recognize different pathogenetic mechanisms. Myeloproliferative markers are specific tests for the diagnosis of ET in children with sporadic forms, while a significant proportion of children with PV can prove negative. (+info)
Molecular findings and antibiotic-resistance in an outbreak of Acinetobacter baumannii in an intensive care unit.
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We investigated an outbreak of Acinetobacter baumannii in the intensive care unit (ICU) of a hospital in Rome, Italy. The outbreak involved 14 patients whose isolates were most frequently recovered from bronchoalveolar lavage. All isolates were multidrug-resistant and showed diminished susceptibility or resistance to carbapenems. A. baumannii strains with a similar antibiotic susceptibility pattern were isolated from the environment. Pulsed-field gel electrophoresis identified a single clone from both the patients' and environmental isolates. Because of the lack of a single source of infection, the eradication of the epidemic required a broad approach, including contact isolation and cohorting, aggressive environmental disinfection, and close monitoring of the ward staff's performance. Infected patients were successfully treated with combined therapy. Although considered of low virulence, A. baumannii can be particularly aggressive and difficult to treat in ICU patients. (+info)
Socioeconomic status and hospitalization in the very old: a retrospective study.
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BACKGROUND: Socioeconomic status could affect the demand for hospital care. The aim of the present study was to assess the role of age, socioeconomic status and comorbidity on acute hospital admissions among elderly. METHODS: We retrospectively examined the discharge abstracts data of acute care hospital admissions of residents in Rome aged 75 or more years in the period 1997-2000. We used the Hospital Information System of Rome, the Tax Register, and the Population Register of Rome for socio-economic data. The rate of hospitalization, modified Charlson's index of comorbidity, and level of income in the census tract of residence were obtained. Rate ratios and 95% confidence limits were computed to assess the relationship between income deciles and rate of hospitalization. Cross-tabulation was used to explore the distribution of the index of comorbidity by deciles of income. Analyses were repeated for patients grouped according to selected diseases. RESULTS: Age was associated with a marginal increase in the rate of hospitalization. However, the hospitalization rate was inversely related to income in both sexes. Higher income was associated with lower comorbidity. The same associations were observed in patients admitted with a principal diagnosis of chronic condition (diabetes mellitus, heart failure, chronic obstructive pulmonary disease) or stroke, but not hip fracture. CONCLUSION: Lower social status and associated comorbidity, more than age per se, are associated with a higher rate of hospitalization in very old patients. (+info)
The effects of a sensitisation campaign on unrecognised migraine: the Casilino study.
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A striking feature of migraine is the difference between the estimated migraine prevalence and the actual number of migraineurs consulting their general practitioners (GPs). We investigated the impact of a sensitisation campaign on migraine in a large cohort of patients, living in a district of Rome. The study involved 10 GPs and a population of about 12 000 people, contacted by mail and posters located in GP clinics. Both the letter and poster stressed the impact of headache on quality of life and included the Italian version of the three-item Identification of Migraine (ID Migraine) screening test, consisting of questions on disability, nausea and photophobia. If the subjects suffered from headaches, they were invited to contact their GPs for a visit and a free consultation with a headache expert. By means of this sensitisation campaign, 195 headache patients consulted their GPs. Ninety-two percent of them (n=179) were migraineurs; 73% of them had never consulted a physician for headache. The ID Migraine test had a sensitivity of 0.92 (95% CI 0.86-0.95), a specificity of 0.75 (95% CI 0.47-0.91) and a positive predictive value (PPV) of 0.97 (95% CI 0.93-0.99) for a clinical diagnosis of migraine, according to the International Headache Society (IHS) criteria. This study confirms that a large number of migraine patients never see a doctor for their headache. This awareness campaign is likely to identify the severest cases of undiagnosed migraineurs. However, mailing campaigns do not seem to be so effective in bringing undiagnosed migraine patients into the primary care setting, and more efficient strategies have to be planned. (+info)
Molecular epidemiology of Escherichia coli producing extended-spectrum beta-lactamases isolated in Rome, Italy.
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Escherichia coli strains producing extended-spectrum beta-lactamases (ESBLs) are a major problem in many different hospitals worldwide, causing outbreaks as well as sporadic infections. The prevalence of Escherichia coli ESBL producers was analyzed in a surveillance study performed on the population attending the Policlinico Umberto I, the largest university hospital in Rome, Italy. We also investigated genotypes, pathogenicity islands, and plasmids in the ESBL-positive E. coli isolates as further markers that are useful in describing the epidemiology of the infections. In this survey, 163 nonreplicate isolates of Escherichia coli were isolated from patients from 86 different wards, and 28 were confirmed as ESBL producers. A high prevalence (26/28) of CTX-M-15 producers was observed within the bacterial population circulating in this hospital, and the dissemination of this genetic trait was associated with the spread of related strains; however, these do not have the characteristics of a single epidemic clone spreading. The dissemination was also linked to horizontal transfer among the prevalent E. coli genotypes of multireplicon plasmids showing FIA, FIB, and FII replicons in various combinations, which are well adapted to the E. coli species. The analysis of related bacteria suggests a probable interpatient transmission occurring in several wards, causing small outbreaks. (+info)
Activity and safety profile of low-dose rituximab for the treatment of autoimmune cytopenias in adults.
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We conducted a retrospective analysis of 11 consecutive patients with various autoimmune cytopenias who failed to respond to conventional treatments and received a fixed-dose regimen of rituximab (100 mg weekly for 4 consecutive weeks). Sustained complete responses were achieved in 4 out of 7 patients with idiopathic thrombocytopenic purpura and in 1 patient with autoimmune pancytopenia. A partial response was observed in 1 patient with autoimmune hemolytic anemia. The immunotherapy had no effect in 1 patient with pure red cell aplasia or in 1 patient with autoimmune neutropenia. No infusion-related or delayed toxicities attributable to rituximab were experienced by any of the patients. (+info)
Comparison between various indices of exposure to traffic-related air pollution and their impact on respiratory health in adults.
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