Anal human papillomavirus in HIV-uninfected men who have sex with men: incidence and clearance rates, duration of infection, and risk factors.

Little is known regarding the natural history of anal human papillomavirus (HPV) infection. We aimed to evaluate incidence and clearance rates, their risk factors, and duration of anal HPV infection in HIV-uninfected men who have sex with men (MSM). A longitudinal study was conducted. Anal samples were analysed using the Linear Array HPV Genotyping test. Incidence and clearance rates, and corresponding risk factors, were estimated using a two-state Markov model. Overall, 155 MSM (median age 33.4 years) attending the largest sexually transmitted infection (STI) centre in Rome, Italy, were followed for a median of 12.2 months (Q1-Q3: 7.0-18.1). Incidence and clearance rates for any HPV were 85.6 (95% CI: 58.4-125.4) and 35.6 (95% CI: 24.7-51.5) × 1000 person-months, respectively; the median duration of infection was 9.4 months (Q1-Q3: 7.5-12.1). Receptive anal sex emerged as the only risk factor for the acquisition of any HPV (Hazard Ratio, HR = 2.65, 95% CI: 1.16-6.06). The incidence rates for carcinogenic and non-carcinogenic types were 42.3 (95% CI: 29.2-61.4) and 29.2 (95% CI: 19.5-43.7) × 1000 person-months, respectively (p = 0.13); their clearance rates were 62.9 (95% CI: 45.1-87.7) and 65.7 (95% CI: 47.4-91.0) × 1000 person-months, respectively (p = 0.83). HPV16 showed the lowest clearance rate among carcinogenic types (59.7 × 1000 person-months), and a duration of infection of 16.8 months. In conclusion, a higher incidence rate was observed for carcinogenic compared to non-carcinogenic HPV types, although the difference was not significant. HPV16 emerged as the type with the longest duration of infection and the lowest clearance rate among carcinogenic types.

Immediate loading: a new implant technique with immediate loading and aesthetics: Nobel Active™.

The aim of this study is to evaluate the short time aesthetic and functional outcome of a new implant system, the Nobel Active™. The Nobel Active™ features several innovations such as an extensive self-drilling capacity, axial and radial bone compression and an inward tapered collar allowing for marginal bone maintance an soft tissue stabilization. This design makes it possible to place the implant into narrower osteotomies, thus requiring less drilling, compared to conventional implants. The Nobel Active™ implants are available in two different prosthetic connections: Internal connection and external connection. The Nobel Active™ External connection is a 1.5 piece implant, with a primary abutment included with the implant. The Nobel Active™ internal connection is a two piece implant with a standard hexagonal internal connection. In this study we present a single tooth replacement with immediate loading of Nobel Active External connection.

Heterogeneity of oral isolates of Candida albicans in HIV-positive patients: correlation between candidal carriage, karyotype and disease stage.

Opportunist infections involving Candida albicans often develop in HIV-positive patients and oral lesions tend to become more frequent as the disease progresses. Previous studies have shown contrasting results concerning the variability of the pulsed-field gel electrophoresis (PFGE) subtypes of C. albicans observed in HIV-positive patients. Carriage of C. albicans was determined by an oral rinse technique; 41 strains of C. albicans (78% serotype A and 22% serotype B) were isolated. There was a direct correlation between candidal load (cfu/ml) and the blood HIV load, whereas there was an inverse correlation with the stage of disease and the CD4 cell counts. The PFGE patterns of isolates were variable with regard to the number and positions of bands. The variability of the band sizes in some run positions showed a Gaussian distribution. Generally, the most frequent size variants were associated with the strains with the highest cfu/ml and lowest CD4 counts (< or =200 cells/microl). These findings suggest a possible strain selection over time during disease progression, especially in HIV-positive subjects with low CD4 counts.

Onychomycosis in Rome, Italy.

This report presents the results of a study conducted between 1985 and 1994 on onychomycosis observed in the city of Rome. Six thousand six hundred and eighty eight patients were examined during this period. Among them 1,762 (26.3%) were affected by fungal nail infections. Because the etiologic agents could not be isolated in 105 cases (6%), the results refer to 1,657 subjects (24.8% of the total), presenting with positive microscopic and cultural examinations. Thirty eight patients (2.3%) had onychomycosis of both their hands and feet. From an etiological point of view, 59.1% of the nail infections were caused by yeasts, 23.2% were infected with dermatophytes and 17.6% by non-dermatophytic fungi. The etiology of onychomycosis of the hands differed from that of the feet. Yeasts were primarily responsible for onychomycosis of the hands (86.2%), while dermatophytes caused tinea unguium peduum (48%). Fungal fingernail infections by Candida spp. were the most common (50.3%), followed by those of the feet by dermatophytes (20%). Candida albicans was responsible for 70.6% of the hand infections but for only 15.9% of those of the feet. Trichophyton rubrum and T mentagrophytes were the most common dermatophytes, mainly causing toenail infections (23.4% and 21%, respectively), while Aspergillus spp., Scopulariopsis brevicaulis, Acremonium spp. and Aspergillus niger were the most common non-dermatophytes observed. With regard to sex, the fungal nail infections were more widespread in women (72.1%) and in subjects of both sexes over the age of 50.

Macroscopic and microscopic characteristics of an African Blastomyces dermatitidis strain.

This report describes the macro- and microscopic characteristics of a strain of Blastomyces dermatitidis isolated in an Italian hospital from a Libyan patient suffering from cutaneous blastomycosis. The fungus was isolated with great difficulty because of the presence of a Proteus species on the lesion. Conversion of the mycelial into the yeast-like phase achieved the best results, using Columbia ANC culture medium. After 5-6 days, this transformation was only partial and presented swollen hyphae and yeast-like cells. The biological characteristics were typical of B. dermatitidis strains of African origin. The differences between African and North American strains are confirmed, in agreement with findings already reported in the literature.

Epidemiology of dermatophytoses observed in Rome, Italy, between 1985 and 1993.

Between 1985 and 1993, 13,880 patients were studied for possible forms of dermatophytoses. The most frequently isolated dermatophyte was in 2821 positive cases Microsporum canis (50%), followed by Trichophyton rubrum (27%), Trichophyton mentagrophytes (10.6%), Epidermophyton floccosum (9.3%), Microsporum gypseum (2.3%), Trichophyton violaceum (0.6%), Trichophyton tonsurans (0.2%) and Trichophyton verrucosum (< 0.1%). The genera and species isolated were also considered in relation to the site of the lesion. Our epidemiological data were compared with those obtained by other authors in other cities and with those obtained in Rome in previous studies conducted between 1972-77 and 1978-83. Results obtained by various investigators in Europe are also discussed.

Keratinophilic fungi in the antarctic environment.

Results of a study on the diffusion of keratinophilic fungi in an Antarctic environment are given. Nine soil samples collected from as many sites along the coast of Ross Sea, and six dust samples inside the Italian scientific base were examined by direct inoculation and hair baiting methods for soil samples and plate dilution method for dust samples. As regards the variety of species isolated and the counting of the numbers of colonies, plate dilution method proved to be very effective. Aspergillus spp., Cladosporium sp., Dematiaceae, Fusarium sp., Geomyces pannorum v. pannorum, G. pannorum v. vinaceus, Mycelia sterilia, Penicillium spp. were isolated from soil. From the dust the following moulds were isolated: Aphanoascus fulvescens, Aspergillus sp., Beauveria sp., Chrysosporium carmichaelii, Dematiaceae, Geomyces pannorum v. pannorum, G. pannorum v. vinaceus, Malbranchea gypsea, Mycelia sterilia, Nectria inventa, Penicillium spp., Scopulariopsis brevicaulis, Scopulariopsis sp. and Trichophyton mentagrophytes. The presence of four colonies of Trichophyton mentagrophytes is emphasized and correlated with the anthropization process.

Isolation of keratinophilic fungi from the dust of ferry boats and trains in Italy.

The occurrence of fungi of the genera Epidermophyton, Microsporum, Trichophyton and Chrysosporium in dust collected from 10 ferry boats and 11 railway cars in Italy was studied. Ferry boats: 101 colonies of fungi were isolated. Of the dermatophytes, E. floccosum represented 2.0% of all the colonies isolated, M. canis 3.0%, M. gypseum 5.0% and Tr. mentagrophytes represented 2.0%. E. floccosum was isolated from 2 ferry boats, M. canis from 3, M. gypseum from 4 and Tr. mentagrophytes from 2. Only two ferry boats appeared to be free of pathogenic fungi. Of all the species isolated, Chr. pannorum was the most numerous (45.4%). In all five species of Chrysosporium were isolated. Railway cars: The final destination of the trains, coming from various cities, was Rome's Termini Station. 336 strains were isolated. The following species were found: E. floccosum 3%, Tr. mentagrophytes 4.8%, Tr. tonsurans 0.3%, Tr. ajelloi 0.6%, Trichophyton spp. 3%, M. canis 5% and M. gypseum 1.5%. Seven different species of Chrysosporium were isolated. Chr. pannorum was the most numerous one (71% of all). Regarding the occurrence of dermatophytes, E. floccosum was isolated from 8 of the 11 trains examined, M. canis from 10, M. gypseum from 4, Tr. mentagrophytes from 8 and Tr. tonsurans from only 1 of the trains. All of the trains were positive for pathogenic fungi, ranging from a minimum of 2 species to a maximum of 4.

The effects of early rearing environments on maternal behavior in adult female rats.

The purpose of this study was to determine the effect of presence of siblings and exposure to colony cues during early life on the onset of maternal behavior at 20 and 75 days of life, and on subsequent emotional behavior in juvenile and adult female rats. Different groups of animals were reared either with a large number or a small number of siblings (sibling factor), or in the colony room or in a room apart from other mothers with pups (colony factor). Animals were tested for latency (in days) to show maternal behavior at either 20 or 75 days of age, and for emotional behavior (using the open field apparatus) at either 20-40 or 80-100 days of age. Exposure to colony sensory cues significantly reduced latencies for pup retrieval and nest-building in adults, but not in juveniles. Exposure to a large number of siblings reduced the latencies, in both adults and juveniles, to nest build; in juveniles, to lie over 75% of the litter; and in adults, to adopt a nursing posture. Consistent with prior research, juveniles had longer latencies than adults for a number of pup-directed behaviors including: latency to become maternal, latency to retrieve pups, latency to adopt a lactating posture, latency to lick/genital lick, and latency to nest-build. In the emotionality tests, the young animals scored as less emotional than the adults, an effect which was further exaggerated by early colony exposure. Overall results indicated that manipulation of early rearing environments does have a significant positive effect on later responses to young pups by both juvenile and adult female rats.

Lesions of the medial preoptic area prevent the facilitation of maternal behavior produced by amygdala lesions.

In the present study we tested the hypothesis that the facilitation of maternal behavior produced by amygdala lesions is mediated through the medial preoptic area. Different groups of animals sustained lesions of the corticomedial amygdala (Group AM), the medial preoptic area (Group MPOA), both regions (Group AM-MPOA), the corticomedial amygdala and non MPOA control sites (Group AM-CX), and control sites (Groups LC or SC). Animals were tested for their maternal responses to foster pups presented daily for an 11 day period. It was found that groups sustaining lesions of the amygdala (Group AM and AM-CX) became maternal more rapidly than did Control Groups (LC and SC), Group MPOA, and Group AM-POA. However, animals in Group AM-POA were similar to Groups AM and AM-CX in that they did not avoid pups, whereas groups not sustaining lesions of the amygdala did. These results, taken together, suggest that amygdala-induced facilitation of maternal behavior in the nulliparous females is mediated through the MPOA. They suggest, moreover, the primary effect of removing the amygdala is to reduce avoidance of pups, with only secondary effects on maternal responsiveness.