Hospitalization rate due to measles in an area of the South East of Italy during an outbreak in the years 2002-2003

AIM

Usually measles is not severe, but serious complications can occur and thus hospitalization is needed. The aim of this study was to assess the reasons of hospitalizations of the persons affected by measles and the severity of disease as a result of measles infection.

METHODS

During an outbreak from 2002 to 2003 in the province of Taranto, 73 hospitalized persons affected by measles were evaluated.

RESULTS

The age of the 73 hospitalized patients ranged between 1 and 42 years old (median age 14.5 years). An hospitalizations rate of 63% was reported in the first 4 months of 2003. Measles-related complications were observed in 35.6% of cases. In 14 cases (19%) we observed a pneumonia with a concomitant myocardititis and pancreatitis in 2 cases. Postmeasles encephalitis was diagnosed in 7 cases (9.5%). In 2 cases a concomitant myelitis occurred, with the presence of sequelae at the time of discharge but none permanent. Measles related appendicitis was observed in 5 males (6.8%) and appendectomy was performed in all cases. Data analysis showed that the patients with an age <15 years old had a higher risk of complications than patients with an age > or =15 years. None death was reported.

CONCLUSIONS

At present, measles and its related complications continue to be a serious illness even in industrialized countries, only a complete immunization vaccine strategy could permit measles' eradication.

Variability in the Interpretation of Transmitted Genotypic HIV-1 Drug Resistance and Prediction of Virological Outcomes of the Initial Haart by Distinct Systems

High level HIV-1 drug resistance in recently infected treatment-naive individuals correlates with sub-optimal virological responses to highly active antiretroviral therapy (HAART). To determine whether genotypic HIV-1 drug resistance in chronic naive patients, as interpreted by various systems, could predict the virological outcomes of HAART, isolates from patients enrolled in a prospective observational cohort (ICoNA) prior to treatment start were genotyped. Genotypic susceptibility scores (GSS) assigned to the initial HAART regimens using the interpretations of pre-therapy resistance mutations by 13 systems were related to virological outcomes. Of 415 patients, 42 (10%) had at least one major resistance mutation. According to the different interpretations, 1.9–20.5% of patients had some level of resistance to at least one drug in the initial regimen. In multivariable analysis, GSS from two systems significantly predicted the time to virological success: Rega 5.5, for each unit increase in GSS adjusted relative hazard (RH) 1.86 [95% confidence intervals (95% CI): 1.15–3.02] and hivresistanceWeb v3, RH 1.87 (95% CI: 1.00–3.48). With three other systems, GSS showed a trend towards a significant prediction of success: Retrogram 1.6, RH 2.33 (95% CI: 0.98–5.53), Menéndez 2002, RH 2.36 (95% CI: 0.97–5.72) and Stanford hivdb, RH 2.06 (95% CI: 0.94–4.49). Genotypic resistance testing coupled with adequate interpretation in chronic naive patients can usefully identify those at risk of sub-optimal virological response to HAART.

The Management of Hepatitis B Virus/HIV-1 Co-Infected Patients Starting Their First Haart Regimen. Treating Two Infections for the Price of One Drug?

We examined the impact of a lamivudine-containing highly active antiretroviral therapy (HAART) regimen on 164 hepatitis B virus/HIV co-infected individuals starting their first HAART. Lamivudine-treated patients (accounting for 73% of the study population) showed a significantly lower level of alanine aminotransferase over follow-up [–81.1 mU/ml mean difference; 95% confidence intervals (95% CI): –30.3; –131.7, P=0.003] and a significantly reduced risk of liver-related morbidity/mortality [Relative hazard (RH)=0.07; 95% CI: 0.01–0.38, P=0.002] than those starting a lamivudine sparing-regimen.

[The use of HIV-1 protease inhibitors. Their effects on AIDS-correlated outpatient and hospitalization activities. A catchment area study]

OBJECTIVE

To evaluate the effects of the use of protease inhibitors (IP) on the out-patient department's activities and hospitalizations of HIV-1 infected subjects.

METHODS

From the December 1996 IP was available in our hospital, so the years 1996 and 1997 were studied.

RESULTS

In the year 1997, 336 patients were visited with an increase of the 41% compared with the year 1996. In the 1997 the 45.2% of hospitalizations were related to AIDS, while in the year 1996 the 65.4% of them were related to AIDS.

CONCLUSIONS

The use of IP had increased the activities of the out-patient department and certainly had a role in reducing the hospitalizations related to AIDS.

[Structure of the periodontal ligament during tooth eruption in the dog: descriptive aspects]

Serially stained uncalcified sections of young dog mandibles were examined to study the structure of the periodontal ligament of the erupting first right molar. The periodontal ligament around tooth crown presents three zones. The first, near the dental follicle, is a tick layer of parallel collagen bundles with numerous flattened fibroblasts. The second, intermediate, contains a blood vessels network, particularly veins and capillaries. The third, outer, is occupied by a continuous layer of osteoclasts and osteoblasts. Also the periodontal ligament around the tooth presents three layers, the outer and the intermediate rich of cells more than the inner. Particularly, the outer layer shows numerous osteoblasts surrounding the developing trabeculae of the alveolar bone and the collagen fiber bundles of the periodontal ligament. These penetrate into the trabeculae and appear similar to the osteoid layer. These results indicate that the alveolar bone increases by ossification of the connective tissue of the periodontal ligament.