The disproportionate case-fatality ratio of COVID-19 between countries with the highest vaccination rates and the rest of the world.

Objectives: The global reported cumulative case-fatality ratios (rCFRs) and excess mortality rates of the 20 countries with the highest coronavirus disease 2019 (COVID-19) vaccination rates, the rest of the world and Sub-Saharan Africa (SSA) were compared before and after the commencement of vaccination programmes. Methods: A time series model was used to understand the trend of rCFR over time, and a generalized linear mixed model was used to understand the effect of vaccination on rCFR. Results: By 31 December 2022, an average of 260.3 doses of COVID-19 vaccine per 100 population had been administered in the top 20 vaccinated countries, compared with 152.1 doses in the rest of the world and 51.2 doses in SSA. The mean rCFR of COVID-19 had decreased by 69.0% in the top 20 vaccinated countries, 26.5% in the rest of the world and 7.6% in SSA. Excess mortality had decreased by 48.7% in the top 20 vaccinated countries, compared with 62.5% in the rest of the world and 60.7% in SSA. In a generalized linear mixed model, the reported number of vaccine doses administered (/100 population) (odds ratio 0.64) was associated with a steeper reduction in COVID-19 rCFR. Conclusions: Vaccine equity and faster roll-out across the world is critically important in reducing COVID-19 transmission and CFR.

Individual growth of Drepanotrema cimex (Pulmonata: Planorbidae) from Arenalcito pond, Natural Reserve Multiple Uses Martin García Island, Buenos Aires, Argentina / Crescimento individual de Drepanotrema cimex (Moricand, 1839) (Pulmonata, Planorbidae) de Arenalcito, Reserva Natural de Usos Múltiples Isla Martín García, Argentina

The species of the genus Drepanotrema, most of them endemic to the Neotropical region, belong to the Planorbidae. Of the nine species of this genus, six are found in Argentina. The present investigation analysed the individual growth of Drepanotrema cimex in Arenalcito pond (34°11 S, 58°15 W), Martín García Island Natural Reserve of Multiple Uses, Buenos Aires Province, Argentina. A total of 14 samples were collected (n = 1931) from February 2006 to June 2007. Five environmental variables were measured: water temperature, dissolved oxygen (mg L1), electrical conductivity (µS cm1), total dissolved solids, and pH. The individual growth of the species was analysed mathematically by means of the von Bertalanffy equation, where: Lt = 5,6(1-e2,0592 (t0,293)). The parameter L was estimated by the Ford-Walford Method. The population of D. cimex was characterised by a complex and dynamic size structure throughout the annual cycle. The analysis of the curves revealed unimodal (2006) and polymodal (April to June 2007) distributions, which pattern served to identify the existence of cohorts within the population studied.

As espécies do gênero Drepanotrema, a maioria delas endêmicas da região Neotropical, pertencem ao Planorbidae. Das nove espécies desta família, seis são encontradas na Argentina. Este artigo analisa o crescimento individual de Drepanotrema cimex na lagoa de Arenalcito, Reserva Natural de Usos Múltiples Ilha Martín García, Buenos Aires, Argentina (34°11 S - 58°15 W). A amostragem foi realizada entre fevereiro de 2006 e junho de 2007. Durante o curso das campanhas foram obtidas 14 amostras (n = 1931). Cinco variáveis ambientais foram medidas: temperatura da água, oxigênio dissolvido (mg L1), condutividade elétrica (uS cm1), sólidos dissolvidos e pH. O crescimento individual das espécies foi analisada matematicamente por meio da equação de von Bertalanffy em que: Lt = 5,6 (1-e2, 0592 (t0, 293)). O paràmetro L foi estimada pe lo método de Ford-Walford. A população de D.cimex foi caracterizada por uma estrutura complexa e dinâmica de tamanho ao longo do ciclo anual. A análise das curvas mostrou distribuições unimodais (2006) e polimodais (abril-junho 2007), identificando a existência de coortes na população estudada.

Individual growth of Drepanotrema cimex (Pulmonata: Planorbidae) from Arenalcito pond, natural reserve multiple uses Martin García Island, Buenos Aires, Argentina.

The species of the genus Drepanotrema, most of them endemic to the Neotropical region, belong to the Planorbidae. Of the nine species of this genus, six are found in Argentina. The present investigation analysed the individual growth of Drepanotrema cimex in Arenalcito pond (34°11' S, 58°15' W), Martín García Island Natural Reserve of Multiple Uses, Buenos Aires Province, Argentina. A total of 14 samples were collected (n = 1931) from February 2006 to June 2007. Five environmental variables were measured: water temperature, dissolved oxygen (mg L-1), electrical conductivity (µS cm-1), total dissolved solids, and pH. The individual growth of the species was analysed mathematically by means of the von Bertalanffy equation, where: Lt = 5,6(1-e-2,0592 (t-0,293)). The parameter L∞ was estimated by the Ford-Walford Method. The population of D. cimex was characterised by a complex and dynamic size structure throughout the annual cycle. The analysis of the curves revealed unimodal (2006) and polymodal (April to June 2007) distributions, which pattern served to identify the existence of cohorts within the population studied.

Mollusks (Gastropoda and Bivalvia) of the Multiple-Use Reserve Martín García Island, Río de la Plata River: biodiversity and ecology.

The Island of Martin Garcia is located in the Upper Río de la Plata, to the south of mouth the Uruguay River. The aim of the present study was to analyse the biodiversity of the island freshwater mollusks and their relationships to environmental variables. Twelve sampling sites were selected, five were along the littoral section of the island and seven were Inland ponds. Seven major environmental variables were measured: water and air temperature, percentage of oxygen saturation, dissolved oxygen, electrical conductivity, total dissolved solids and pH. Twenty-seven mollusk species were found, Antillorbis nordestensis, Biomphalaria tenagophila tenagophila , B. t. guaibensis, B. straminea, B. peregrina, Drepanotrema kermatoides, D. cimex, D. depressissimum, Chilina fluminea, C. rushii, C. megastoma, Uncancylus concentricus, Hebetancylus moricandi, Stenophysa marmorata, Heleobia piscium, H. parchappii, Potamolithus agapetus, P. buschii, P. lapidum, Pomacea canaliculata, P. megastoma, Asolene platae, Corbicula fluminea, Eupera platensis, Pisidium sterkianum, P. taraguyense and Limnoperna fortunei. UPGMA clustering of species based on their occurrence in different ecological conditions revealed two main species groups. The Canonical Correspondence Analysis suggests that the species distribution is related to the physico-chemical condition of water. Axis two of the ordination diagram displayed the approximately 95.6% of the correlation between species and environmental variables. Dissolved oxygen, conductivity, water temperature and pH showed the highest fluctuations during the sampling period. The species richness (S) showed relationships mainly with water temperature and conductivity. The biodiversity of the gastropods and bivalves from Martín García Island amounts to up to 26 species. Among the Gastropoda, the Planorbidae family made the most sizeable contribution. The Lithogliphidae P. agapetus (26.28%) and P. buschii (9.50%) showed the highest relative frequencies of occurrence within the littoral environments, while the Planorbidae D. cimex (23.83%) and D. kermatoides (11.59%) likewise did so in the inland ponds.

[Efficient prevention of overweight and obesity in the experience of family practitioners and "nutrition units" of the public health system in Lombardy]. / La prevenzione efficace del sovrappeso e dell'obesità sul territorio, esperienza in Lombardia fra u.o. nutrizione del SIAN e medici di famiglia.

General practitioners (GP's) presence is homogeneously distributed in the Lombardy territory. GP's are easy accessible by people so they could play a key role in the prevention of overweight and obesity. In this study GP's included in everyday medical activity a primary prevention strategy regarding nutrition and lifestyle. The goal was to maintain a constant BMI for one and a half year for at least 50% of the patients (stable means without progression within BMI's range). During the same time another endpoint was to decrease from 1 to 3 units the BMI in overweight patients in half of the observed population. Subjects were randomly recruited during routinely ambulatory activity, without a specific BMI based selection. Diet quality was assessed with a food frequency questionnaire regarding "protective foods" as vegetables, fruits and legumes. Some "basic" information about nutrition and lifestyle where then provided through explanation of issues printed on A4 page brochure. Percentage BMI's range variation before and after the intervention show a stability in the observed population, with an increase 0,3% for normal weight males and 0,9% for females. BMI was constant in 72,2% of the subjects considering a 1 unit variation and in 92,2% considering 3 units variation. Within subjects who varied 1 unit (27,7%) more subjects decreased rather than gained weight (16% vs 11,7%); within subjects who varied 3 units (7.8%), 4,5% decreased and 3,3 increased their BMI. GP's demonstrate to have an efficient role in weight gain control with a simple and regular prevention strategy towards healthy lifestyles and simple nutritional tips. It is important for patients to comprehend the importance the doctor give to the overweight and obesity problem, apart from the medical issue considered during the visit. GP's have a key role for healthy life-style change programs among their patients. These results provide new arguments about the opportunity to invest public resources towards population (managed in collaboration with GP's coordinated by a public health department such as NU), rather than towards a single patient. The project management was supervised by the Nutrition Unit (NU) of the public heath system SIAN (ASL di Brescia).

[A new case of hepatic adenomatosis. A critical review of the literature]. / Un nuovo caso di adenomatosi epatica. Revisione critica della letteratura.

Liver adenomatosis is a rare disease--only 22 cases are previously described--characterized by multiple adenomas (more than ten) in a normal parenchyma. After a literature review the authors cannot exclude a link between the estroprogestatives use and the development of adenomatosis. Most important risks are bleeding and development of new adenomas, after the operation. On the basis of an extensive literature review, diagnosis features, treatment and follow-up are discussed. The aim of this report is to describe a case of multiple adenomas in a 38 years old housewife treated for seven years with oral contraceptives, admitted to hospital for spontaneous subcapsular haemorrhage due to rupture of adenomas, macroscopically considered suggestive of angiomas during the operation. Right lobectomy was performed and microscopic examination diagnosed multiple adenomas (liver adenomatosis). A repeated CT scan eight months later showed more than three new nodules in the liver. A new right lobectomy and tumorectomy of the nodules in III liver segment (remained after the first operation for the erroneous diagnosis) was performed and over a period of 20 months the patient remains in excellent condition.

[Hepatic cystadenocarcinoma]. / Cistoadenocarcinoma epatico.

The biliary cystadenocarcinoma is a rare liver neoplasm with a preoperative difficult diagnosis to make, but increased by ultrasonography. Is reported the case of a caucasian male 78 years old, operated 11 years previously for partial resection of a benign liver cyst. Recurrent cholangitis and obstructive jaundice required a reoperation for right hepatectomy. Microscopic examination showed a malignant transformation in cystadenocarcinoma.

[The spontaneous rupture of a pyogenic liver abscess. A clinical case]. / Rottura spontanea di ascesso epatico piogenico. Caso clinico.

The authors report a case of a large monolocular liver abscess in a patient with gallbladder and choledocic stones and biliary stent, complicated by rupture into the peritoneal cavity, that required surgical treatment. Surgical exploration versus other approach results the choice treatment, as shown by resolution of the pathology.

Prevalence of Helicobacter pylori in asymptomatic population--a pilot serological study in Bangladesh.

Epidemiological reports reveal that H. pylori is distributed among all population in the world. The present cross-sectional study was undertaken to see the H. pylori seroprevalence rates among the asymptomatic adults, as yet reportedly no such data available in Bangladesh. Serum samples were collected from 181 consecutive subjects who attended at the health check-up centre of Bangladesh Institute of Diabeties, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, during the period of August to November 1995 for medical check up. The mean age of these subjects was 30.33 years (range 20-44 yrs). Incidentally all were male and belonged to average socioeconomic class. H. pylori specific IgG antibody level was assayed by an enzyme immunoassay kit ElAgen (Clone system). Among the 181 subjects, 166 (92%) had H. pylori specific antibodies and 15 (8%) were seronegative. No significant difference (p < 0.90) in seroprevalence rates was observed among different age groups. However, the results of higher seroprevalence rates of H. pylori infection in these asymptomatic adult population of Bangladesh are consistent with that of Africa and India.

Spatial and seasonal trends of a natural population of Biomphalaria occidentalis in northeastern Argentina.

This study aims to analyze the age structure of a population of Biomphalaria occidentalis on a pond of Riachuelo river basin, which is one of the three most important Middle Paraná river affluents in Corrientes province. Samples were drawn from three stations, where spatial and temporal numerical variations of the snail, as well as its relation with different environmental parameters, mainly temperature, rainfall, pH and conductivity, were analyzed. Snail abundance is given in number of individuals/hour. The differences between the three sampling stations, estimated by nonparametric tests, was nonsignificant. A relative scale to the greatest shell diameter was employed to build the age pyramids. Temporal fluctuations of snail abundance correlated negatively with the highest monthly accumulated temperatures (P < 0.05). Although different floristic compositions were observed at the three stations, no significant numerical variations were detected in B. occidentalis spatial distribution. Reproductive activity took place between March-April and November with overlapping cohort system. During summer (December-February) mortality increased along with temperature and reproductive activity was not evident.

Potential schistosome-vector snails and associated trematodes in ricefields of Corrients province, Argentina. Preliminary results.

Considering the possibility of introduction of schistosomiasis mansoni into Argentina as a consequence of dam construction on the Rio De La Plata basin, preliminary studies have been carried out on agrosystems such as ricefields in Corrientes province with the following purposes: 1) to survey and estimate the relative abundance of planorbids and identify potential vector species; 2) to identify environmental factors capable of influencing Biomphalaria population dynamics; and 3) to find out snail-parasite associations and estimate snail infection rates in order to detect possible competitive interactions between larval stages of native trematodes that could be used in biological control of Schistosoma mansoni. Three potential schistosome vectors were detected in ricefields, namely Biomphalaria straminea, B. tenagophila and B. peregrina, although B. orbignyi, a species refractory to infection with S. mansoni, proved the most frequent and abundant. Positive correlations (P less than 0.05) were found between Biomphalaria abundance and some environmental parameters: conductivity, hardness, calcium, nitrites plus nitrates, ammonium and bicarbonates. Water temperature correlation was negative (P less than 0.05). No correlation (P less than 0.05) was found in total iron, phosphates (SRP), pH and soil granulometry.

[Difficulties in interpreting a conspicuous retroperitoneal hematoma due to rupture of the inferior pancreatico-duodenal vessels at the onset of edematous-type acute pancreatitis]. / Difficoltà interpretative di cospicuo ematoma retroperitoneale da rottura dei vasi pancreatico-duodenali inferiori all'esordio di pancreatite acuta di tipo edematoso.

The authors report on a case of conspicuous retroperitoneal haematoma with haemoperitoneum due to rupture of the lower pancreatico-duodenal vessels appearing at onset of an acute oedematous pancreatitis. After stressing the rarity of this event, the authors go on to discuss a number of aetiopathogenetic, diagnostic and therapeutic aspects.

Esophageal achalasia. Diagnostic and therapeutic implications.

Over an 11-year period, 15 patients underwent surgery for achalasia (Heller's operation with added antireflux procedure). Thereafter due to the use of manometry 25 other achalasic patients were diagnosed and 17 of them underwent the same surgical procedure. Manometry was done by means of a triple-lumen catheter as described by Arndorfer. Surgical results in the first group were good in 80% and moderate in 20% with no recurrence or organic complications due to acid reflux, while in the second group good results were 95%. In 16 cases of the second group, diagnosis was based on manometric recordings, since the radiological findings were lacking. Early diagnosis enabled to operate on selected patients according to the motor findings of the esophageal body. Follow-up by manometry revealed in some cases an increase in post-deglutitory motor activity and in two cases a return of a coordinated peristalsis. Clinical and functional results are discussed and the role of manometric studies is stressed in order to improve the knowledge of the pathophysiology of functional diseases of the esophagus.

[A case of epithelial cyst of the spleen]. / Un caso di cisti splenica epiteliale.

The Authors report a rare case of an epithelial cyst of the spleen treated successfully by splenectomy. The nomenclature, the diagnostic techniques and the therapeutic principles are discussed.

[Clinical and endoscopic follow-up of gastrectomized patients Billroth II technic for benign pathology]. / Verifica clinica ed endoscopica di gastroresecati secondo Billroth II per patologia benigna.

A follow up was performed in 109 patients primarily undergone Billroth II resection for benign gastric or duodenal diseases to analyze mucosal changes, possibility of premalignant lesions and importance of causal factors in aetiology of gastric stump cancer. Moreover, clinical status and haematological parameters for nutritional assessment are examined to identify indicators of postgastrectomy sequelas.