Pregnancy in a methylmalonic acidemia patient with kidney transplantation: a case report.

Presently pregnancy is no more exceptional in women with metabolic diseases. However, it still poses significant medical problems both before and after childbirth. The challenge is even greater if the mother has undergone organ transplantation, because of her metabolic disease. We report on a case of pregnancy in a patient 29-year-old with methylmalonic acidemia cblA type (OMIM 251100) who received a renal transplantation at the age of 17 for end-stage renal disease (ESRD) caused by her primary disease. During pregnancy neither metabolic crises nor renal function changes were observed in the mother, with the only exception of a mild increase of her systemic blood pressure. To the fetus pregnancy was uneventful and during the first 30 months after birth the baby's neuropsychomotor development was normal and there were no episodes of metabolic derangement. This is evidence that methylmalonicacidemia cblA, even when treated with renal transplantation for inherent ESRD, is no contraindication to pregnancy. It is even possible that a functioning transplanted kidney contributes to improve metabolic parameters.

Safety and tolerability of Meningococcus B vaccine in patients with chronical medical conditions (CMC).

BACKGROUND: Invasive meningococcal disease is a serious global health threat in the world; in 2016, the European Centre for Disease Control and Prevention reported 3280 confirmed cases (including 304 deaths) of Invasive Meningococcal Diseases in Europe. In Italy, in 2017 were reported 200 cases 41% of which due to menB serogroup. From January 2013 the European Medicines Agency (EMA) has authorized the marketing of the meningococcal B vaccine 4CMenB. METHODS: The study aimed to evaluate and complement the safety profile of 4CMenB in high risk children accessing the vaccine service of the Bambino Gesù Children's Hospital. All individuals aged six weeks or more receiving the meningococcal 4CMenB (Bexsero®) vaccine that approached the vaccine Centre at the Bambino Gesù Children's Hospital in Rome, were asked to participate. All parents or caregivers of vaccinated individuals in the study period, were recruited and requested to answer to a questionnaire on adverse events following immunization (AEFI) observed after 7 days, starting from the date of vaccination. RESULTS: During the study period (October 2016-October 2017), we collected 157 completed questionnaires (out of 200 distributed). Of those 132 were first doses and 25 were booster administered doses. The median age of the study population was 4.5 years (range 0.29 to 26.8 years), the majority of subjects were high-risk individuals (64%) with chronic health conditions. Overall, 311 adverse events were reported in the 7 days after vaccine administration. In particular 147 events (47%) after administration of first dose and 58 (19%) after the booster doses. A large majority of those events, were of little clinical importance and concentrated in the 24 h after vaccine administration. No hospitalizations or Emergency Department access were reported. CONCLUSIONS: Results of our study demonstrated that the Bexsero® vaccine is almost well tolerated, with a low incidence of severe AEFIs. Our results also shown that the occurrence of AEFIs is similar within healthy and high risk children.

[Evaluation of the immune status against poliomyelitis in a group of young immigrants]. / Valutazione dello stato immunitario verso la poliomielite in un campione di giovani immigrati.

The immunity state towards poliomyelitis has been evaluated in 506 young immigrants coming from European and extraeuropean countries without immunization history. Polioviruses 1, 2 and 3 antibodies were detected in 97% of the serum samples. 15 subjects did not have detectable antibodies at 1:2 dilution for one or two polioviruses. Out of these subjects, 6 (coming mostly from East European Region) were negative in the undiluted serum too. On the whole, GMTs for type 1 (43,29) and 2 (41,9) appeared higher than those for type 3 (33,6). Moreover there are differences among the origin countries; in fact, GMTs more elevated for type 1 and 3 (74,6 and 49,6 respectively) have been observed in the subjects coming from the African region, as well in those coming from the American region.

[Measurement of anti-HBs antibodies in a population of 18-year-olds 6 years after the primary vaccination series]. / Valutazione degli anticorpi anti-HBs in un campione di diciottenni a 6 anni dal ciclo vaccinale primario.

We have analized the persistence of vaccine-induced antibodies to hepatitis B surface antigen, in a cohort of 445 eighteen-year-old males, who had been immunized against hepatitis B six years earlier (when they were 12 years old, according to the Italian law). These young men were about to begin their military service and were going through the routine check-up. They came from two different towns Reggio Emilia and Mantova, in the north of Italy, and were divided into two groups (group A no 258 men, group B no 187 men) depending on where they had been vaccinated. The serologic results showed that 97% of subjects had anti-HBs and 94% anti-HBs protective levels (> or = 10 mIU/ml). Moreover 81% of responder subjects showed titles > or = 100 mIU/ml, and 25% showed titles even > or = 1000 mIU/ml. Anti-HBs GMT of the total responders was 367.1. Differences have been found in the anti-HBs levels of men vaccinated in the two different towns.

Environmental surveillance of poliovirus in Italy: pilot study.

A pilot study on environmental surveillance of poliovirus included one hundred ninety-six samples (drinking water, surface water, seawater and sewage), collected between 1996 and 1998 in different regions of Italy. Samples were screened for the presence of poliovirus and other enteric viruses. Twelve polioviruses, 35 non polio enteroviruses (NPE) and 51 enteric non entero (NE) viruses were isolated. All poliovirus isolates, namely four type 1, four type 2 and four type 3, were characterised as Sabin-like strains. Thirty-one Coxsackie B and 4 Echo viruses were also detected. The presence of Sabin-like polioviruses in the environment is not unexpected since immunization with only oral poliovirus vaccine was performed in Italy until May 1999, when a sequential schedule consisting of two doses of inactivated polio vaccine (IPV) and two of oral polio vaccine (OPV) was adopted; in July 2002 a schedule consisting of four doses of IPV was adopted. Although this is only a pilot study and the number of samples analysed is limited, so far data from this study so far supports once again evidence of lack of circulating wild poliovirus and is in line with results from AFP surveillance in Italy and stool survey on healthy children.

Comparison of times of intervention during pediatric CPR maneuvers using ABC and CAB sequences: a randomized trial.

BACKGROUND: The proposed introduction of the CAB (circulation, airway, breathing) sequence for cardiopulmonary resuscitation has raised some perplexity within the pediatric community. We designed a randomized trial intended to verify if and how much timing of intervention in pediatric cardiopulmonary resuscitation is affected by the use of the CAB vs. the ABC (airway, breathing, circulation) sequence. PATIENTS AND METHODS: 340 volunteers, paired into 170 two-person teams, performed 2-rescuer healthcare provider BLS with both a CAB and ABC sequence. Their performances were audio-video recorded and times of intervention in the two scenarios, cardiac and respiratory arrest, were monitored. RESULTS: The CAB sequence compared to ABC prompts quicker recognition of respiratory (CAB vs. ABC=17.48 ± 2.19 vs. 19.17 ± 2.38s; p<0.05) or cardiac arrest (CAB vs. ABC=17.48 ± 2.19 vs. 41.67 ± 4.95; p<0.05) and faster start of ventilatory maneuvers (CAB vs. ABC=19.13 ± 1.47s vs. 22.66 ± 3.07; p<0.05) or chest compressions (CAB vs. ABC=19.27 ± 2.64 vs. 43.40 ± 5.036; p<0.05). CONCLUSIONS: Compared to ABC the CAB sequence prompts shorter time of intervention both in diagnosing respiratory or cardiac arrest and in starting ventilation or chest compression. However, this does not necessarily entail prompter resumption of spontaneous circulation and significant reduction of neurological sequelae, an issue that requires further studies.

[Researches on the water quality of the river Po and its tributaries between Cremona and Casalmaggiore. I. materials and methods (author's transl)]. / Indagini sulla qualità delle acque del fiume Po e dei suoi affluenti nel tratto Monte Cremona-Casalmaggiore. Nota I: materiali e metodi

During 1971 a research program about the status of pollution of the river Po and its tributaries was started by six Institutes of Hygiene altogether (Turin, Pavia, Milan, Parma, Modena and Ferrara Universities) with the Institute for Water Research of C.N.R. and Hydrographic Office of Magistracy of the Po. The role of the Parma University Hygiene Institute was to study the water qualities of the river Po between Cremona and Casalmaggiore and of two right side tributaries, Arda-Ongina and Taro. The hydrogeographical characteristics of the examined reach are reported in the present note, with special reference to the hydrological conditions, basin area, inhabitants and industrial typology. The sampling stations were placed upstream and downstream Cremona town, near Casalmaggiore and at the mouth of Arda-Ongina and Taro. Moreover the methods, for chemical and bacteriological analysis are reported.

[Studies on the quality of water of the right side tributaries of the Po River; Trebbia and Nure, in 1971-1973]. / Indagine sulla qualità declle acque degli affluenti di destra del Po, Trebbia e Nure nel periodo 1971-73

In the period 1971-73 samplings were taken out monthly at the mouths of the two right side tributaries of the river Po, Trebbia and Nure. The aim of the research was to value the water quality, the polluted load conveyed to the river Po and to compare the real load with the one estimated on the basis of inhabitants and the basin area. Both the water courses are torrent-like rivers with highflow values in the winter and low flow values in the summer (July and August). There are no important industries in the basins studied and the high polluted effluents, mainly domestic and agricultural discharges, are placed in the plain tracts of the rivers at few kilometers from the mouths. As far as the water quality of both rivers is concerned, most of the chemical parameters maintain suitable levels for fish life and drinking purposes; on the contrary the microniological indexes exceed the limits for bathing fixed by the Italian Ministry of Health by 100 E.coli 100/ml. and by 1000 total coliforms 100/ml. in about 90 and 70-80% of samplings. The comparison between real and calculated loads has shown a good agreement for BOD and chloride in Trebbia and for BOD and phosphates in Nure.

[Research on the quality of the Po River and its tributaries in the region of Cremona-Casalmaggiore mountain. III. 1972-1973]. / Indagini sulla qualità delle acque del fiume po e dei suoi affluenti nel tratto Monte Cremona-Casalmaggiore. Note III: periodo 1972-1973

The analises of water samples collected during the second research period, year 1972-73, in the tract of the river Po from Cremona to Casalmaggiore partly confirmed the results obtained in the first period (1971-72). However we have to consider that during this second research year the hydrological conditions of the river Po have been very similar to the average ones of the last 30-40 years. The fact is particularly important and it permitted us to better value all those parameters which feel the effects of the flow variations. Also in this second period the different parameters didn't present significative variations upstream and downstream Cremona and at Casalmaggiore except the turbid load as happened in 1971-72 period. As far as the water qualities are concerned no significative differences have been registered between the two paeriods; in fact the most part of the physioco-chemical parameters keep suitable levels for fish life and drinking purposes; meanwhile, except some particular situations, the microbiological indexes exceed the limits for bathing waters fixed by the W.Q.C. and by the Italian Ministry of Health.

[Studies on the water quality of the river Po and its tributaries between Monte Cremona and Casalmaggiore. II. Period 1971-2]. / Indagini sulla qualità delle acque del fiume Po e dei suoi affluenti nel tratto Monte Cremona-Casalmaggiore. Nota II: Periodo 1971-2

The results relating to the research carried out on the river Po upstream and downstream Cremona town, at Casalmaggiore and at the mouths of the right side tributaries Arda-Ongina and Taro in the period 1971-72 are reported in the present note. The samplings took place once every month and on the same day flow measurements were effected by the Magistracy of the river Po in the five stations. The results of this first series of sampling have shown a good stability of the water quality of the river Po, in the different seasons and in the different hydrological conditions. No significative differences were poi nted out for the most part of the determined parameters between the stations upstream and downstream Cremona and Casalmaggiore, except the turbid load (turbidity, suspended matter at 105 degrees C, setteable solids) which presented at Casalmaggiore an average value absolutely higher than the calculated one which was achieved considering concentrations and river flow at Cremona and at the mouths of Arda-Ongina and Taro. With few exceptions the water quality keeps a good level for fish life and its actual pollution degree let us think it possible to improve the situation in a short time. Only microbiological parameters are excepted, as they exceed the proposed limits for recreation and bathing uses (W.Q.C.).