Three cases of scombroid syndrome in Italy: clinical and preventive considerations.

Background: Foodborne diseases are common sources of morbidity and mortality worldwide. Scombroid syndrome represents a particular condition since it is not directly related to the ingestion of spoiled food but is determined by high levels of histamine, a chemical mediator naturally produced within the human body under particular conditions. In these cases, histamine is formed as a result of the bacterial activity from histidine, an amino acid present at high levels in some fish species. The resulting symptomatology can range from mild symptoms such as headache and skin rash to more severe manifestations such as hypotension and coronary spasms. Reference regulations in Italy set maximum levels of histamine in food at 200 mg/kg. Cases description: The cases described involve a family of three who, following the ingestion of a tuna dish, started to exhibit symptoms typical of an allergic reaction. In one case, hypotension, tachycardia, and electrocardiographic changes in the ST-tract suggestive of myocardial ischemia also appeared with negative myocardionecrosis enzyme dosage. All three cases experienced complete remission of symptoms in the absence of sequelae. Histamine concentrations in fish sampled three days later were 169 mg/kg. Conclusion: The cases described emphasize the importance of proper differential diagnosis as well as the importance of implementing specific controls in food hygiene.

Certification and prescription in the diabetology field: occupational and medico-legal aspects.

Abstract: Diabetes mellitus is an ever-increasing disease and is defined as a "social disease" due to the significant economic damage it causes to the affected individuals and the community involved in its care. This paper presents the process of certification of diabetic disease and the application for invalidity in order to obtain welfare and economic benefits provided by law; it, also, describes the prescription process and the appropriateness of therapeutic prescription for the diabetic patient in terms of clinical-prescriptive appropriateness and economic-prescriptive appropriateness. Finally, it reports on the side effects of the most common antidi-abetics, the off-label use of metformin and the physician's responsibili-ties in the light of the Gelli-Bianco law.

A driving simulation study on the effects of different wine types on the performance of young drivers.

BACKGROUND: Alcohol consumption is responsible for a significant number of road fatalities. To contrast this phenomenon, a more responsible attitude to the wine consumption, especially among young, inexperienced drivers prone to risky behaviour on the road must be promoted. METHOD: This is a simplified single-blind, placebo-controlled experiment aimed at evaluating 44 young drivers monitored during a driving simulation following the consumption of natural and conventional wines, with a reference blood alcohol concentration (BAC) of 0.5 g/l. Two hypotheses are tested: (1) the legal consumption of wine has no significant impact on young drivers' performance in both ordinary and unusual road events; (2) natural and conventional wines are expected to produce negligible and acceptable impairments in young drivers the same BAC. Two reference groups (BAC = 0 g/l), one a placebo-controlled group with drivers treated with a dealcoholized wine, were included. RESULTS AND CONCLUSIONS: Significant differences between the groups in terms of perception and reaction times (PRT) to visual and auditory stimuli, and to speeding were observed, with young drivers treated with conventional wine displaying more aggressive behaviours. In contrast, participants treated with natural wine showed PRT which were not significantly different from those belonging to control groups. The gaze attention levels of wine treated drivers were found to be dose dependant, with young drivers of the two control groups and those of the treated ones with BAC < 0.3 g/l able to focus on wider area ahead and, thereby, collect more information from the road environment.

Outbreak of mortality in Russian (Acipenser gueldenstaedtii) and Siberian (Acipenser baerii) sturgeons associated with sturgeon nucleo-cytoplasmatic large DNA virus.

Diseased outbreaks with high mortality in farmed sturgeon are a limiting factor to the success of this emerging aquaculture sector in Europe. Thorough investigations of outbreaks can determine the aetiological agents, identify important pathological and epidemiological pathways of infections and pave the way for effective control strategies. A thorough investigation of a mortality outbreak in Russian (Acipenser gueldenstaedtii) and Siberian (Acipenser baerii) sturgeons in Italy, demonstrated the primary involvement of a sturgeon nucleo-cytoplasmic large DNA virus (NCLDV). While, the taxonomy classification of this new virus is still uncertain, its involvement in sturgeon mortality outbreaks in Europe is, for the first time, fully investigated and described. Furthermore, the coinfection of bacteria such as motile Aeromonas spp. and Acinetobacter spp. was reported. Genetic characterisation showed the close relationship between the European sturgeon NCLDV with North American sturgeon NCLDVs. Similarly to the latter, the European sturgeon NCLDV persists in survivors. Furthermore, a systemic distribution of the European sturgeon NCLDV was evident in diseased A. baerii and A. gueldenstaedtii and in recovered A. gueldenstaedtii. These epidemiological and pathological findings will help in the identification of effective control strategies for sturgeon NCLDV infection, which afflicts an important and emerging European aquaculture sector.