Serologic and molecular survey for hepatitis E virus in wild boar (Sus scrofa) in Central Italy.

The aim of this study was to further investigate the role of wild boar (Sus scrofa) as a reservoir for hepatitis E virus (HEV). Sixty-four blood and faecal samples collected from wild boar hunted in Central Italy in 2011-2012 were examined by indirect enzyme-linked immunosorbent assay and RT-PCR analysis. Positive RT-PCR samples were further examined by nucleotide sequence determination and subsequent phylogenetic analysis. Thirty-six sera (56.2%) were positive for HEV-specific antibodies, and six (9.4%) faecal samples scored RT-PCR-positive results. Four animals were positive by both enzyme-linked immunosorbent assay and RT-PCR. Phylogenetic analysis showed that the detected wild boar-derived HEV sequences clustered within genotype 3, with similarity to sequences of human origin collected in a nearby area in 2012. Our data confirm that HEV is endemic in the wild boar population in the research area and that these wild animals could play an important role in the epidemiology of HEV infection.

Methadone dosages and therapeutic compliance during a methadone maintenance program.

In 97 heroin addicts in a methadone maintenance treatment program (MMTP) with social services, urine screening for opioid metabolites identified groups with different treatment compliance. The positive correlation between compliance and methadone dosage confirms that MMTPs are effective in rehabilitating patients when 'adequate' dosage, i.e., capable of preventing relapse, is used.

Renal tubular dysfunction in chronic alcohol abuse--effects of abstinence.

BACKGROUND: Alcohol abuse may be accompanied by a variety of disorders of electrolyte and acid-base metabolism. The role of the kidney in the pathogenesis of these disturbances is obscure. We sought to evaluate the alcohol-induced abnormalities of renal function and improvement during abstinence and to assess the relation between renal dysfunction and electrolyte and acid-base disorders. METHODS: We measured biochemical constituents of blood and renal function before and after four weeks of abstinence in 61 patients with chronic alcoholism who had little or no liver disease. RESULTS: On admission, 18 patients (30 percent) had hypophosphatemia and hypomagnesemia, 13 patients (21 percent) had hypocalcemia, and 8 patients (13 percent) had hypokalemia. Twenty-two patients (36 percent) had a variety of simple and mixed acid-base disorders. Twenty of these patients had metabolic acidosis, and among them, 80 percent had alcoholic acidosis. A wide range of defects in renal tubular function, with normal glomerular filtration rate, were detected in these patients. The defects included decreases in the threshold and maximal reabsorptive ability for glucose (38 percent of patients) and in the renal threshold for phosphate excretion (36 percent); increases in the fractional excretion of beta 2-microglobulin (38 percent), uric acid (12 percent), calcium (23 percent), and magnesium (21 percent); and aminoaciduria (38 percent). Seventeen patients (28 percent) had a defect in tubular acidification, and five an impairment in urinary concentrating ability. Urinary excretion of N-acetyl-beta-D-glucosaminidase and alanine aminopeptidase were increased in 41 and 34 percent of patients, respectively. The abnormalities of blood chemistry and renal tubular function disappeared after four weeks of abstinence. CONCLUSIONS: Transient defects in renal tubular function are common in patients with chronic alcoholism and may contribute to their abnormalities of serum electrolyte and blood acid-base profiles.

[Visceral larva migrans. Report of 3 cases]. / Larva migrans visceral--relato de três casos.

We report three cases of children with visceral larva migrans confirmed by enzyme-linked immunosorbent assay (ELISA), in Goiânia. Pulmonary interstitial infiltrates with dry cough and peripheral eosinophilia characterised the first case. Clinical and laboratorial finding in the second case included dry cough, pulmonary infiltrates, peripheral eosinophilia and hypergammaglobulinaemia. A persistent eosinophilia, between 1987-1989, without apparent cause led to the confirmation of parasite infection in the third case.

Results of surgical intervention in the symptomatic multiply-operated back patient. Analysis of sixty-seven cases followed for three to seven years.

Sixty-seven of seventy-three patients who had had multiple operations on the back with an initial diagnosis of lumbar-disc disease were reevaluated as to relief of pain two and four years after the most recent operation. More than 80 per cent of the patients had gained enough relief to deem the procedure worth while. A diagnosis of fibrosis, preoperatively or intraoperatively, portended a poor result, while the opposite was true with diagnoses of mechanical compression (disc fragment or stenosis) and instability (pseudarthrosis after fusion or spondylolisthesis). The presence of a pain-free interval lasting one year from the date of the previous operation correlated highly with the presence of a surgically remediable lesion.