An acute febrile outbreak in a refugee community of an Italian asylum seeker center: lessons learned.

OBJECTIVES: The management of infectious outbreaks in closed settings represents an important public health issue. An outbreak of acute febrile syndrome affecting 22 refugees resident at the Asylum Seekers Centre of Castelnuovo di Porto in Rome has been reported, and the preventive and control measures adopted have been described as an example of public health safety. METHODS: Pharyngeal swab and whole-blood samples were collected from 22 cases observed and analyzed for standard bacterial cultures and respiratory and herpesviruses by qualitative CLART PneumoVir2 and Entherpex microarray. RESULTS: A possible respiratory-transmitted etiology and a concomitant reactivation of multiple herpesviruses have been evidenced. The epidemiological investigation showed that the spread of the epidemic was promoted because patients were hosted in neighboring rooms or in the same room, facilitating the rapid spread of infectious disease. CONCLUSIONS: The potential way of transmission was supposed, and preventive measures for infection control were adopted. The measures adopted are an example of best practice for outbreak management, and the microbiological surveillance is recommended for public health improvement.

Experimental methodology for digital breast shape analysis and objective surgical outcome evaluation.

Outcome evaluation in cosmetic and reconstructive surgery of the breast is commonly performed visually or employing bi-dimensional photography. The reconstructive process in the era of anatomical implants requires excellent survey capabilities that mainly rely on surgeon experience. In this paper we present a set of parameters to unambiguously estimate the shape of natural and reconstructed breast. A digital laser scanner was employed on seven female volunteers. A graphic depiction of curvature of the thoracic surface has been the most interesting result. Further work is required to provide clinical and instrumental validation to our technique.

Heavy metals in coastal water systems. A case study from the northwestern Gulf of Thailand.

A geochemical survey of the northwestern part of the Thailand Gulf (Inner Gulf) was carried out in order to define concentrations and distribution patterns of selected heavy metals (V, Cr, Co, Ni, Cu, Zn, and U) in the coastal system and estuarine area of the Mae Klong river. The results indicate the presence of two different sources of heavy metals in the studied environment and allowed us to identify a lithogenic component that significantly influences the composition of coastal waters and suspended particulate matter (SPM). Comparison of the normalized heavy metals concentrations both in the studied samples and in those reported for the Sn-W ores present in the surrounding areas suggests an important anthropogenic contribution to the chemistry of the seafloor sediments. Vanadium and nickel enrichment factors (EF) calculated for coastal waters indicate that contamination by hydrocarbons discharge took place in the investigated area.

[A 52 year-old woman with fever, cough and dyspnoea]. / Donna di 52 anni con febbre, tosse e dispnea.

A 52 year-old woman with gastric cancer treated with surgery and chemotherapy, is admitted in our Internal Medicine Department because of the presence of fever (max 41.2 degrees C), dyspnoea, non-productive cough and mental confusion. The anamnesis and the physical examination address to the diagnosis of CAP (Community-Acquired Pneumonia); in particular the alteration of consciousness and the onset of symptoms after the insertion of a nose-gastric tube let us to consider the diagnosis of aspiration pneumonia. The clinical presentation and radiological imaging (Rx and CT of thorax) suggest the pattern of bronchiolitis obliterans with organizing pneumonia (BOOP). BOOP is not a disease, but a non specific pattern of answer to a lung injury. It can be either idiopathic or associated with a variety of causes, such as infections, drugs, radiations and connective tissue diseases. Besides the clinical course is complicated by the onset of an ARDS (Adult Respiratory Distress Syndrome). The gold standard for the diagnosis is represented by lung biopsy with hystopathologic confirmation but, if it cannot be done, it's necessary to start immediately steroid therapy because BOOP may be fatal. The patient received antibiotic and steroid therapy with success.

[Multiple cerebral tuberculomas resistant to conventional therapy in an immunocompromised subject]. / Tubercolomi cerebrali multipli resistenti alla terapia convenzionale in un soggetto immunosoppresso.

A 33 years old immunocompromised woman was admitted for a fever of unknown origin during the last five months. She referred a body temperature up to 38.3 degrees C, headache, weakness. The physical examination revealed right homonymous hemianopia, hyperreflexia and Babinski on her right side. A TC scan and a following bioptic specimen showed multiple cerebral tuberculomas. A conventional therapy was started but no significative improvement was observed. She was finally treated with interferon gamma and GM-CSF in addition to the therapy with an important regression of the lesions and significative improvement of the fever and neurological findings.