Ranavirus infection-induced avoidance behaviour in wood frog juveniles: do amphibians socially distance?

Hosts may limit exposure to pathogens through changes in behaviour, such as avoiding infected individuals or contaminated areas. Here, we tested for a behavioural response to ranavirus infection in juvenile wood frogs (Rana sylvatica) because the majority of dispersal between populations occurs during this life stage. We hypothesized that if infections are transmissible and detectable at this life stage, then susceptibles would display avoidance behaviours when introduced to an infected conspecific. Despite no apparent signs of infection, we observed a greater distance between susceptible-infected pairs, compared to pairs of either two infected or two susceptible animals. Further, distances between susceptible-infected pairs were positively related to the infection intensity of the focal exposed frog, suggesting the cue to avoid infected conspecifics may become more detectable with more intense infections. Although we did not quantify whether the transmission was affected by their distancing, our findings suggest that juvenile frogs have the potential to reduce terrestrial transmission of ranaviruses through avoidance behaviours.

Reconstructing historical exposure to asbestos: the validation of 'educated guesses'.

BACKGROUND: In both the epidemiological and legal context, the causal attribution of asbestos-related lung diseases requires retrospective exposure assessment (REA). AIMS: To assess the correlation between the retrospective assessment of occupational and anthropogenic environmental exposure to asbestos and its content in the lung tissue. METHODS: Based on the available exposure information, a team of occupational physicians retrospectively assessed cumulative exposure to asbestos in 24 subjects who died of asbestos-related diseases. The asbestos lung content was analysed using analytical scanning electron microscope (SEM-EDS). The Log10 asbestos fibre count in the autoptic samples was predicted as a function of the Log10 estimated cumulative exposure using univariate regression analysis. RESULTS: The median count of asbestos fibres by grams of dry weight (ff/gdw) in the lung tissue was 81 339 (range 0-2 135 849.06); it was 287 144 (range 0-2 135 849.06) among the occupationally exposed, and 29 671 (range 0-116 891) among the subjects who only had anthropogenic environmental and/or household exposure. Amphiboles, and particularly amosite (52%) and crocidolite (43%), were detected in all the study subjects. Chrysotile was not detected in any of the samples. Overall, the retrospective estimate of lifetime cumulative exposure to asbestos showed a moderate correlation with the total asbestos fibre count in the autoptic lung, with the regression model explaining 38-55% of the total variance. CONCLUSIONS: Detailed information on occupational, environmental and household exposure circumstances would be indispensable for experienced industrial hygienists and/or occupational physicians to reliably assess past exposure to amphiboles or mixed types of asbestos.

Source and symptoms of COVID-19 among hospital workers in Milan.

BACKGROUND: Healthcare workers (HCWs) are commonly infected by SARS-CoV-2 and represent one of the most vulnerable groups. Adequate prevention strategies are necessary to guarantee HCWs' safety, as well as to prevent dissemination of the infection among patients. AIMS: To describe a case series of SARS-CoV-2-positive HCWs in a large public healthcare organization in Milan (Italy) during the most devastating weeks of the epidemic and analyse the sources, symptoms and duration of SARS-CoV-2 infection. METHODS: This study included 172 SARS-CoV-2-positive HCWs who were infected between the 25th of February and the 7th of April 2020. A nasopharyngeal swab (NPS) and RT-PCR were used to indicate. RESULTS: Initially, the most common sources of infection were other positive HCWs (49%). Medical doctors and nursing assistants were most frequently infected, with infection rates of 53/1000 and 50/1000, respectively. COVID-19 departments were less affected than internal medicine, surgery, intensive care, or emergency room. The most commonly reported symptom was mild cough, while loss of smell (anosmia) and loss of taste (ageusia) were reported as moderate and severe by 30-40% of HCWs. The time necessary for 50% of workers to recover from the infection was 23 days, while it took 41 days for 95% of HCWs to become virus-free. CONCLUSIONS: HCWs are commonly infected due to close contacts with other positive HCWs, and non-COVID departments were most affected. Most HCWs were asymptomatic or subclinical but contact tracing and testing of asymptomatic HCWs help identify and isolate infected workers.

Seasonal dynamics and potential drivers of ranavirus epidemics in wood frog populations.

Epidemics in wildlife populations often display a striking seasonality. Ranaviruses can cause rapid, synchronous mass mortality events in populations of wood frog (Rana sylvatica) larvae in the summer. While there are several possible explanations for this pattern-from seasonal introductions of the virus to environmental stressors to windows of susceptibility to mortality from infection during development-most studies have focused on single factors in laboratory settings. We characterized the time course of ranavirus epidemics in eight ephemeral ponds in Connecticut, USA, measuring the prevalence and intensity of infections in wood frog larvae and Ranavirus DNA in water samples using environmental DNA methods. We found little evidence that the timing of pathogen introduction affected the timing of epidemics (rising prevalence) or the resulting die-offs. Instead, we observed a pulse in transmission asynchronous with die-offs; prevalence reached high levels (≥ 50%) up to 6 weeks before mortality was observed, suggesting that die-offs may be uncoupled from this pulse in transmission. Rather, mortality occurred when larvae reached later stages of development (hind limb formation) and coinciding water temperatures rose (≥ 15 °C), both of which independently increase pathogenicity (i.e., probability of host mortality) of infections in laboratory experiments. In summary, the strong seasonality of die-offs appears to be driven by development- and/or temperature-dependent changes in pathogenicity rather than occurring chronologically with pathogen introduction, after a pulse in transmission, or when susceptible host densities are greatest. Furthermore, our study illustrates the potential for eDNA methods to provide valuable insight in aquatic host-pathogen systems.

Axillary basal cell carcinoma: additional 25 patients and considerations.

BACKGROUND: Axillary basal cell carcinoma represents a rarely described occurrence in world literature. OBJECTIVE: To report our 14 years' experience of axillary basal cell carcinomas. METHODS: A review of Pathology department database is given. RESULTS: Twenty-five further patients with axillary basal cell carcinomas of 7367 basal cell carcinomas diagnosed are reported. These represent a percentage of 0.33%.The average age of patients was 64.96 years, not significantly different from the average age of patients with overall basal cell carcinomas. No patient had had previous radiant or immunosuppressive treatment or axillary sunburn. No patient had basal cell naevus syndrome. The subtypes involved were superficial and nodular. No patient of 17 patients followed up had recurrences or metastasis after 5 years of follow-up. CONCLUSION: Axillary Basal cell carcinomas are rare. No particular predisposing or risk factor is recorded. They do not seem to be significantly more aggressive than other basal cell carcinomas.

Spindle and/or epithelioid cells nevi in pediatric age: are they different from those of adults? A clinical review of 187 cases.

AIM: Spindle and/or epithelioid cells nevi represent the spectrum of a clinico-pathologic entity with different characteristics. Aim of the study is to provide information about the differences in characteristics of these nevi for different groups of age. METHODS: Two different groups are considered: younger than 15 years and older than 15 years. An analysis of 187 spindle and/or epithelioid cells nevi was performed. Forty-five pediatric patients (24 males and 21 females) and 142 adult patients (44 males and 98 females) were examined. Age, sex, type of nevus, location, clinical characteristics were evaluated. RESULTS: Spindle and epithelioid cells nevi were observed in 53% of the pediatric and in 45% of adult patients. Female more frequently presented with spindle nevus cell both in pediatric (56%) and in adult (70%) cases. In pediatric patients, the anatomical distribution was prevalent in the areas of the head and neck. Pigmentation was not a distinctive feature of pediatric cases and only interested the spindle and epithelioid cells nevi. The regularity of borders was not a distinctive character for neither of the groups of patients. Uniformity in color occurred more frequently in pediatric patients. CONCLUSION: Spindle and/or epithelioid nevi belong to the same spectrum of pathologies, they behave differently in the different groups of age thus permitting a certain degree of clinical distinction in different age groups.

[Diet as a key element of health promotion at the workplace in scientific research and practice. First results of the EU project FAHRE]. / La dieta come elemento cardine della promozione della salute ne luoghi di lavoro nella ricerca scientifica e nella pratica. Primi risultati del progetto EU FAHRE.

The globalization of markets have led to rapid changes in diet and lifestyle in the developed countries, where living standards have improved, and availability and variety of food has increased while physical activity decreases have led to an augment in chronic diseases (obesity and diabetes mellitus), cardiovascular diseases and some specific cancers. In this context there is a need to develop health promotion activities. Workers represent a very appropriate group for such activities because they are relatively homogeneous, easily reachable because they can be found together in the same place and time and the occupational physician has good knowledge of the of health status of individual worker. In this scenario, a renew interest must be posed to the relationship between diet and health. In this context our Group is participating at the FAHRE project (Food and Health Research in Europe). The project aims to establish the state of the art of research at the interface of nutrition and health in the European Union, identifying its strengths and weaknesses in order to propose strategies to increase coordination and improve its functioning as a European Research Area.

Ulno-basilic arteriovenous fistulae: indications and surgical technique.

Ulnar-basilic fistula is a vascular access option for hemodialysis first reported in 1967. There is no inherent reason why the ulnar artery cannot be used to create a fistula at the wrist; however, a few reports dealing with its complications and survival rates have been published in the literature. In the present work the results of 9 ulnar-basilic fistulae done in 9 adults patients on chronic hemodialysis, are reported. Two fistulae were created as primary access and the remaining 7 fistulae as secondary access after thrombosis of an ipsilateral and controlateral radiocephalic fistula in 6 cases and in a case of high-flux brachiocephalic fistula. No episodes of surgical complications were observed. This fistula is an additional option to create a distal vascular access for hemodialysis before constructing a proximal access.

Roles of corticotropin-releasing factor, neuropeptide Y and corticosterone in the regulation of food intake in Xenopus laevis.

In mammals, hypothalamic control of food intake involves counterregulation of appetite by an orexigenic peptides such as corticotropin-releasing factor (CRF), and orexigenic peptides such as neuropeptide Y (NPY). Glucocorticoids also stimulate food intake by inhibiting CRF while facilitating NPY actions. To gain a better understanding of the diversity and evolution of neuroendocrine feeding controls in vertebrates, we analysed the effects of CRF, NPY and glucocorticoids on food intake in juvenile Xenopus laevis. We also analysed brain CRF and NPY mRNA content and plasma corticosterone concentrations in relation to nutritional state. Intracerebroventricular (i.c.v.) injection of ovine CRF suppressed food intake while CRF receptor antagonist alpha helical CRF(9-41) significantly increased food intake relative to uninjected and placebo controls. By contrast, i.c.v. injection of frog NPY and short-term corticosterone treatment increased food intake. Semi-quantitative reverse transcription-polymerase chain reaction analyses showed that CRF and NPY mRNA fluctuated with food intake in the brain region containing the mid-posterior hypothalamus, pretectum, and optic tectum: CRF mRNA decreased 6 h after a meal and remained low through 31 days of food deprivation; NPY mRNA content also decreased 6 h after a meal, but increased to prefeeding levels by 24 h. Plasma corticosterone concentration increased 6 h after a meal, returned to prefeeding levels by 24 h, and did not change with prolonged food deprivation. This postprandial increase in plasma corticosterone may be related to the subsequent increase in plasma glucose and body water content that occurs 24 h postfeeding. Overall, our data support the conclusion that, similar to other vertebrates, CRF is anorexigenic while NPY is orexigenic in X. laevis, and CRF secretion modulates food intake in the absence of stress by exerting an inhibitory tone on appetite. Furthermore, the stress axis is activated in response to food intake, but in contrast to mammals and birds is not activated during periods of food deprivation.

[Smoking in the workplace. Study at a hospital in central Italy]. / L'abitudine al fumo di tabacco nei luoghi di lavoro. Studio in un'Azienda Ospedaliera dell'Italia centrale.

Smoking is the leading preventable cause of death and the source of numerous problems in the workplace. This study assessed the smoking in health care workers in a general hospital in Central Italy. As part of the health surveillance required by Law No. 626/1994, 2743 employers (40.8% males, 59.2% females; mean age 42.0 ys, SD 9.6 ys) were interviewed. The prevalence of smokers was very high: 36.0% in men and 36.7% in women. When the population was stratified according to occupation, the highest prevalence of smokers was found in ward orderlies (45.2%) and nurses (38.9%) and the lowest in doctors (26.3%). The prevalence of smoking was similar in all occupational divisions--clinical, surgery, diagnostics and administration. This study shows that smoking is more widespread in hospital workers than in an age-matched section of the general population (27.5%). As all health workers should set a positive example in combatting smoking, occupational physicians in charge of health surveillance in hospitals should actively collaborate in smoking dissuasion programmes.

[Monoclonal gammopathy of uncertain significance in rheumatic disease]. / Le grammapatie monoclonali di incerto significato nelle malattie reumatiche.

Among 358 patients with rheumatic diseases, the incidence of monoclonal gammopathy of undetermined significance (MGUS) as detected by immunofixation was 4.4% (11 of 248 patients) in rheumatoid arthritis (RA), 3% (1 of 32 patients) in systemic lupus erythematosus (SLE), 6% (3 of 49 patients) in Sjögren's syndrome (SS) and 3% (1 of 29 patients) in progressive systemic sclerosis (PSS). Solid tumor was present in 4 (36%) of the 11 RA-MGUS patients. In these cases the monoclonal component could be related to a paraneoplastic syndrome rather than to rheumatic diseases. The association of rheumatic diseases, MGUS, solid tumor and immunological disorders are discussed.

[Cutaneous side effects induced by D-penicillamine in the treatment of rheumatoid arthritis]. / Gli effetti collaterali cutanei indotti dalla D-penicillamina nel trattamento della artrite reumatoide.

After considering the cutaneous side effects of D-penicillamine in rheumatoid arthritis management, a few cases of cutaneous adverse reaction observed in 5 (13%) of 38 patients, who received the drugs, are described. Two patients had an early rash; one showed a late rash; one had a late rash with symptoms of initial pemphigus and drug-induced LES (presence of antinuclear and anti-dsDNA antibodies). Finally, one patient showed a drug-induced pemphigus with high titre of reticular anti-skin antibodies. All these manifestations required definitive discontinuance of the drug.

Intestinal calcium absorption in rheumatoid arthritis. A study using whole body counting.

Conflicting results are reported in the literature concerning the changes in intestinal calcium absorption in rheumatoid arthritis (RA). In the present work, intestinal calcium absorption was studied in 27 postmenopausal women with RA, using whole body counting as the study method and orally administered Ca-47 as the tracer. Nobody was on corticosteroid therapy, but all received non-steroidal anti-inflammatory drugs and hydroxy chloroquine or gold compounds. The mean calcium absorption was 22.3% of the dose administered, with a standard deviation of 8.0%. The results obtained were not significantly different from those of 40 age- and sex-matched controls (mean +/- SD: 22.0% +/- 6.0%). Our findings seem to exclude the hypothesis of calcium malabsorption as one of the causes leading to osteoporosis in RA.

Temporal arteritis in seropositive rheumatoid arthritis with rheumatoid nodule.

A 61-year-old woman, suffering from classic seropositive rheumatoid arthritis with rheumatoid nodule histologically documented, developed temporal arteritis. HLA-DR typing revealed the presence of DR3 and DR4 antigens. The findings from previous studies support the association of HLA-DR antigens, giant cell arteritis-polymyalgia rheumatica and rheumatoid arthritis, and suggest the participation of a common immunogenetic mechanism in their pathogenesis.