Low cadmium concentration in whole blood from residents of northern Sardinia (Italy) with special reference to smoking habits.

INTRODUCTION: The present study was initiated to investigate the cadmium concentrations in whole blood of Northern Sardinian, non-occupationally exposed adult subjects. Sardinia is a large Italian island which differs genetically and environmentally from other mainland Italian areas. METHODS: Two hundred and forty-three adults (157 females and 86 males) were selected in the study area from subjects who were undergoing blood collection for laboratory analysis during the period January 2005-May 2005. Whole blood was analysed by graphite furnace atomic absorption spectrometer equipped with a Zeeman-effect background corrector (Perkin Elmer ZLS5100) and an auto sampler. The adopted analytical procedure uses the Stabilized Platform Temperature Furnace (STPF) technique. RESULTS: The mean value of Blood Cadmium Concentration (BCdC), expressed as Geometric Mean, was 0.32 pg/l (CI 95%: 0.31-0.34 l) in non-smokers to 034 pg/l (CI 95%: 0.30-0.39 pg/l) in ex-smokers up to 0.47 gg/ll(CI 95%: 0.42-0.53 pg/l) in smokers (p < 0.0001). DISCUSSION: The results show that BCdC levels in Northern Sardinian non-occupationally exposed adults are lower than levels found in many other regions, including those within Italy. Nevertheless, similar values have been detected in other European countries and cities. CONCLUSIONS: In relation to other reports in which data were analysed by strata for smoking habit and age, we found similar BCdC values among non smokers. However, Sardinian smokers seem to show lower levels of blood cadmium.

A fatal postpartum Clostridium sordellii associated toxic shock syndrome.

Clostridium sordellii is an infrequent human pathogen. It has been demonstrated to be occasionally responsible for myonecrosis or gas gangrene. Interestingly, in the obstetric literature, some cases of postpartum maternal deaths have been associated with C sordellii infection causing a rapidly lethal toxin mediated syndrome. This is the first reported case of postpartum death in a 29 year old woman, in which a toxigenic C sordellii was isolated from the patient's blood antemortem during the fatal toxic shock, strongly indicating its role in this rare syndrome.

Prospective study of Yersinia enterocolitica infection in thalassemic patients.

We determined prospectively during a 12-month period the incidence, clinical characteristics and outcome of Yersinia enterocolitica infection in 144 thalassemic patients (mean age, 12.8 years) and compared them with 100 controls (mean age, 12.1 years). Symptomatic Y. enterocolitica infection occurred in 14 (10%) of the thalassemic patients and in 2 (2%) controls (P = 0.017). Of the 14 thalassemic patients 5 (36%) had septicemia and 9 (64%) had focal infection (enteritis in 8 and tonsillitis in 1). One control patient had acute enteritis and the other had tonsillitis. All isolates from these patients belonged to pathogenic phenotypes of Y. enterocolitica. Pending culture results symptomatic thalassemic patients discontinued treatment with deferoxamine and were treated with intravenous antibiotic therapy. Patients with the ultimate diagnosis of focal Y. enterocolitica infection continued treatment with intramuscular ceftriaxone or intravenous trimethoprim/sulfamethoxazole (TMP/SMX) for 7 days, whereas those with septicemia continued treatment with intravenous TMP/SMX for 14 days. The outcome was favorable in all 14 thalassemic patients. We conclude that Y. enterocolitica is a significant cause of morbidity in our patients with thalassemia and that prompt antibiotic therapy might prevent life-threatening conditions as well as a complicated course with long term sequelae.

Yersinia enterocolitica causing suppurative arthritis of the shoulder.

Yersinia enterocolitica is a rare cause of extra-intestinal disease. A case in a 60 year old butcher with hepatic cirrhosis who developed suppurative arthritis of the shoulder caused by Y enterocolitica is presented. There was no evidence of gastrointestinal infection or septicaemia. The severity of the illness was associated with various factors, including the underlying disease, the type of occupation, and the difficulties encountered in defining the optimal therapeutic regimen.

First reported case of Streptococcus pyogenes infection with toxic shock-like syndrome in Italy.

A 43-year-old male who sustained a superficial hand injury developed streptococcal toxic shock-like syndrome and died within 48 hours. The clinical course of the illness in this previously well patient was rapid and fulminant. The organism responsible was a group A beta-hemolytic streptococcus which was identified as opacity factor negative, M serotype 1, T type 1. The organism produced streptococcal pyrogenic exotoxins B and C, but no detectable exotoxin A although it carried speA, the gene for exotoxin A. This is the first case reported in Italy, and further emphasizes the virulence of these organisms and the rapidity with which the illness can progress.

[HIV infection in northwestern Sardinia]. / L'infezione da HIV nella Sardegna nord occidentale.

The prevalence of anti HIV antibodies was investigated in the sera of 150 drug addicts and of 62 patients not drug addicts hospitalized in the Institute of Infectious diseases of the University of Sassari in the years 1980-86. No seropositivity was detected in not drug addicts patients in the years of observation and in the drug addict ones in the years 1980-81-82. The seropositivity discovered in 1983 in 24% of drug addicts raised to 75% in the first 8 months of 1986. As regards the prevalence of anti HIV antibodies in 1986 the sera of different categories were investigated. Seropositivity was detected in 55% of 20 drug addicts prisoners, in 6.25% of 16 homosexual men, 13 of which prisoners and 3 drug addicts, in 3.7% of 27 transfused individuals, 26 of which under dyalitical treatment, and in 33.3% of sexual partners of HIV positive patients. Anti HIV antibodies were not detected in the sera of 20 laboratory workers, 22 prisoners with a negative history for homosexuality and drug addiction, 45 prison guards and 100 individuals taken at random from general population. The stages of infection in 27 drug addicts were classified according to Atlanta CDC criteria as follows: 63% of cases asymptomatic, 22.2% persistent generalized lymphoadenopathy, 7.4% minor clinical features, 3.7% serious clinical picture, 3.7% full clinical picture of AIDS.

[Salmonella infections in workers at food shops during the period 1979-1985 in the province of Sassari]. / Infezioni da salmonella in operatori del settore alimentare nel periodo 1979-1985 nella provincia di Sassari.

Various categories of subjects working in food shops were tested for Salmonellae. The strains were isolated through serological typing and testing for sensitivity to antibiotics allowed us to know the epidemiological situation of those microorganisms in our area and their variations compared to previous studies.