Eslicarbazepine acetate as adjunctive treatment in partial-onset epilepsy.

OBJECTIVE: The aim of the study was to assess the clinical response to eslicarbazepine acetate (ESL) as add-on therapy in adult patients with partial-onset epilepsy by means of the time-to-baseline seizure count method. METHODS: We retrospectively identified consecutive patients with partial-onset seizures, with or without secondary generalization, prescribed to ESL add-on therapy. The primary endpoint was the time-to-baseline monthly seizure count. Subgroup analysis was performed according to carbamazepine (CBZ)/oxcarbazepine (OXC) status (prior vs never use). Secondary outcomes were the rate of treatment-related adverse events (AEs) and the AEs affecting ≥5% of patients. RESULTS: One-hundred and eighteen patients were included. The median time-to-baseline monthly seizure count was 46 (35-101) days in the overall study cohort. The number of concomitant anti-epileptic drugs (AEDs) was associated with the time-to-endpoint (adjusted hazard ratio [adj HR]=2.22, 95% CI 1.18-4.14, P=.013 for two AEDs vs one; adj HR=3.65, 95% CI 1.66-8.06, P=.001 for three or more AEDs vs one). Groupwise, the median times-to-baseline seizure count were 47 (35-97) and 43 (34-103) in patients with prior and never exposure to CBZ/OXC, respectively (P for log-rank test=.807). Adverse events occurred in 53.4% (63 of 118) of patients; the most frequently reported were dizziness (13.6%), somnolence (11.9%), nausea (6.8%), and fatigue (5.1%). CONCLUSIONS: Add-on ESL improved seizure control and was overall well-tolerated in adult patients with partial-onset epilepsy.

Experimental infection of rock pigeons (Columba livia) with three West Nile virus lineage 1 strains isolated in Italy between 2009 and 2012.

West Nile virus (WNV) circulation dynamics in the context of the urban environment is not yet elucidated. In this perspective, three groups of eight rock pigeons (Columbia livia) were inoculated with three WNV lineage 1 strains isolated in Italy between 2009 and 2012. The pigeons did not develop any clinical signs consistent with WNV acute infection. All animals seroconverted and shed virus up to 15 days post-infection by the oral or cloacal routes. In all infected groups viraemia lasted for 4 days post-infection. No WNV-specific gross or histological lesions were found in infected birds compared to control birds and immunohistochemistry remained constantly negative from all tissues. The reservoir competence index was also assessed and it ranged between 0·11 and 0·14. This study demonstrates that pigeons are competent reservoir hosts for Italian WNV lineage 1 circulating strains thus potentially posing a risk to the public health system.

West Nile virus lineage 2 in Sardinian wild birds in 2012: a further threat to public health.

West Nile virus (WNV) strains belonging to lineage 2 were detected and isolated from the tissues of a goshawk and two carrion crows in Sardinia in August 2012. According to NS3 sequence analysis, the Sardinian isolates shared a high level of similarity with those of Italian lineage 2 strains which circulated in 2011 and with the homologous sequence of the 2004 Hungarian isolate. Following the human fatality reported in 2011 in Olbia, this study is the first to report the spread and enzootic circulation of WNV lineage 2 in Sardinia.

The role of CEUS in the characterization of hepatocellular nodules detected during the US surveillance program--current practices in Europe.

The basic pathological feature for the differential diagnosis between hepatocellular carcinoma (HCC) and non-malignant hepatocellular nodules in cirrhotic patients detected during ultrasound (US) is the vascular supply to the nodule. Computed tomography (CT) and magnetic resonance imaging (MRI) are considered reference imaging techniques for depicting hepatocellular nodule vascularity in the noninvasive diagnosis of HCC. Contrast-enhanced US (CEUS) improves the diagnostic performance of unenhanced US in the diagnosis of HCC, giving an overall diagnostic accuracy that is similar to that of CT, even for nodules smaller than 2 cm. An additional diagnostic feature of CEUS relative to CT is the possibility to visualize contrast wash-in to hepatic nodules during the arterial phase and contrast washout during the portal venous and late phases. Sensitivity for the diagnosis of HCC with combined assessment of CEUS and CT is higher than for separate assessments of CEUS and CT due to the reduction of false-negative findings. CEUS represents a competitive imaging method from an economic point of view, and is an effective imaging tool for assessing the therapeutic outcome after surgery, ablation therapy, and transarterial chemoembolization (TACE).

Functional MRI during the execution of a motor task in patients with multiple sclerosis and fatigue.

PURPOSE: This study was undertaken to assess cortical activation during execution of a motor task in patients with multiple sclerosis (MS) and fatigue. MATERIALS AND METHODS: We enrolled 24 right-handed patients affected by relapsing-remitting MS and mild disability (12 with and 12 without fatigue) and 15 healthy volunteers. Magnetic resonance imaging (MRI) examination (1.5 T) was performed with conventional sequences and an echoplanar imaging (EPI) sequence for functional MRI (fMRI). The motor task consisted of sequential finger tapping performed with the right hand. Statistical maps of motor activation were obtained. Comparison between the two subgroups of patients and between patients and controls was performed with analysis of variance (ANOVA) statistical analysis (p<0.05). RESULTS: Compared with controls, patients without fatigue showed greater activation of the primary sensorimotor cortex bilaterally, of the right supplementary motor cortex, of the left premotor cortex, of the left cerebellum and of the superior parietal lobule bilaterally. Compared with patients without fatigue, patients with fatigue demonstrated greater activation of the right premotor area, of the putamen and the dorsolateral prefrontal cortex. CONCLUSIONS: Patients with fatigue have greater activation of the motor-attentional network when performing a simple motor task.

[Production cycles and risk agents in the agri-food sector]. / I cicli produttivi ed i relativi fattori di rischio nel settore agroalimentare.

Italian Food Processing Section includes primary sector (agriculture, fishing and farming), secondary industry and service sector (trade, transport and marketing). The whole process is structured in a sequence of production structures, which constitute a die. The most important food processing dies are fruit and vegetable, cereals, wine, oil, bovine, swine and avian breeding, fishing, milk and cheese. Every die presents very different production cycles, jobs and working professionals. Considering the heterogeneity of food processing dies, all occupational risk factors, such as chemical, biological, physical, ergonomic, psychosocial and injuries risks, are very frequent in such working activities. In a pilot study carried out in the province of Foggia (Apulia, Southern Italy) we showed that the major perceived risk factors where dust and physical overload in the cereal-pasta processing die, and noise and awkward postures in olive-oil die. However, perceived risk factors are biased by low risk perception due to poor information about health occupational hazards, this representing an important health safety problem. For this reason, the activity of preventive authorities at various levels is highly recommended.

[Musculoskeletal disorders among university student computer users]. / Disturbi muscolo-scheletrici in studenti universitari che utilizzano il computer.

BACKGROUND: Musculoskeletal disorders are a common problem among computer users. Many epidemiological studies have shown that ergonomic factors and aspects of work organization play an important role in the development of these disorders. OBJECTIVES: We carried out a cross-sectional survey to estimate the prevalence of musculoskeletal symptoms among university students using personal computers and to investigate the features of occupational exposure and the prevalence of symptoms throughout the study course. Another objective was to assess the students' level of knowledge of computer ergonomics and the relevant health risks. METHODS: A questionnaire was distributed to 183 students attending the lectures for second and fourth year courses of the Faculty of Architecture. Data concerning personal characteristics, ergonomic and organizational aspects of computer use, and the presence of musculoskeletal symptoms in the neck and upper limbs were collected. RESULTS: Exposure to risk factors such as daily duration of computer use, time spent at the computer without breaks, duration of mouse use and poor workstation ergonomics was significantly higher among students of the fourth year course. Neck pain was the most commonly reported symptom (69%), followed by hand/wrist (53%), shoulder (49%) and arm (8%) pain. The prevalence of symptoms in the neck and hand/wrist area was signifcantly higher in the students of the fourth year course. DISCUSSION: In our survey we found high prevalence of musculoskeletal symptoms among university students using computers for long time periods on a daily basis. Exposure to computer-related ergonomic and organizational risk factors, and the prevalence ofmusculoskeletal symptoms both seem to increase significantly throughout the study course. Furthermore, we found that the level of perception of computer-related health risks among the students was low. Our findings suggest the need for preventive intervention consisting of education in computer ergonomics.

Western Bluetongue virus serotype 3 in Sardinia, diagnosis and characterization.

Over the last 20 years, Italy has experienced multiple incursions of different serotypes of Bluetongue virus (BTV), a Culicoides-borne arbovirus, the causative agent of bluetongue (BT), a major disease of ruminants. The majority of these incursions originated from Northern Africa, likely because of wind-blown dissemination of infected midges. Here, we report the first identification of BTV-3 in Sardinia, Italy. BTV-3 circulation was evidenced in sentinel animals located in the province of Sud Sardegna on September 19, 2018. Prototype strain BTV-3 SAR2018 was isolated on cell culture. BTV-3 SAR2018 sequence and partial sequences obtained by next-generation sequencing from nucleic acids purified from the isolate and blood samples, respectively, were demonstrated to be almost identical (99-100% of nucleotide identity) to BTV-3 TUN2016 identified in Tunisia in 2016 and 2017, a scenario already observed in past incursions of other BTV serotypes originating from Northern Africa.

Fast capacitive probe for electromagnetic pulse diagnostic.

In this work, we report the study and the development of a capacitive probe which is suitable for getting fast and high voltage/current measurements. Due to the fact that fast pulses propagate generally in coaxial structures, the probe realized in this work was a capacitive divider with the divider electrode properly designed to assure the same characteristic impedance of the coaxial structure and the recombination time of the split signals during the propagation. It was a folded cylindrical ring of 1.4 cm long and 0.8 cm thick, which introduce a theoretical delay time of about 100 ps. Analyzing the behavior of the probe closed on 520 Omega, the voltage amplification resulted to be of (3.6+/-0.1) x 10(-4) and, as a consequence, the current attenuation factor of 56+/-1 AV. The response rise time was less than 320 ps, which was limited by oscilloscope bandwave. The capacitor probe can operate voltage measurements of the order of 100 kV.

Detection and quantification of Anaplasma marginale DNA in blood samples of cattle by real-time PCR.

A TaqMan-based real-time PCR assay was developed for the diagnosis of Anaplasma marginale infection of cattle. The established assay was proven to be highly specific, since no cross-reactions were observed with other Anaplasma species of ruminants, including the closely related Anaplasma centrale, or other haemoparasites of ruminants (Anaplasma bovis, Anaplasma ovis, Anaplasma phagocytophilum, Babesia bovis, Babesia bigemina, Theileria annulata and Theileria buffeli). The detection limit was equal to that of nested (n)PCR (10(1) copies of standard DNA and 3 x 10(1) infected erythrocytes ml(-1) of blood). The assay was also reproducible, as shown by satisfactory low intra-assay and inter-assay coefficients of variation. Fifty-four blood samples of ruminants (cattle, n = 51; sheep, n = 2; goats, n = 1), that had been tested previously by reverse line blot (RLB) hybridisation, were subjected to an nPCR assay and the newly established real-time PCR assay. By using real-time PCR, A. marginale DNA was detected in 39/51 bovine samples, with DNA titres ranging from 3.60 x 10(3) to 5.70 x 10(8) copies ml(-1) of blood, whereas sheep and goat samples tested negative. The concordance with nPCR was 100%, whereas a unique sample that had tested negative by RLB gave positive results by nPCR and real-time PCR. The established assay could overcome the limitations of existing diagnostic methods, allowing for simultaneous detection and quantification of the A. marginale DNA in bovine blood, that is essential to support the clinical diagnosis, to assess the carrier status of the animals and to evaluate the efficacy of vaccines and antirickettsial drugs.

Infectious canine hepatitis: an "old" disease reemerging in Italy.

Four outbreaks of infectious canine hepatitis (ICH) occurring in Italy between 2001 and 2006 are reported. Three outbreaks were observed in animal shelters of southern Italy, whereas a fourth outbreak involved two purebred pups imported from Hungary few days before the onset of clinical symptoms. In all outbreaks canine adenovirus type 1 (CAV-1) was identified by virus isolation and PCR. In three outbreaks, other canine viral pathogens were detected, including canine distemper virus, canine parvovirus or canine coronavirus. The present study shows that CAV-1 is currently circulating in the Italian dog population and that vaccination is still required.

[A workplace intervention aimed at increasing awareness in nursing personnel performing manual handling activities]. / La consapevolezza come obiettivo formativo del personale sanitario addetto alla movimentazione di pazienti: esperienza di un nuovo metodo educativo.

Here we describe a workplace intervention aimed at reducing the risk of low back pain in nursing personnel. The intervention we carried out included a specific ergonomic training and an exercise program according to the Feldenkrais Method. After the intervention, we evaluated its effect on the execution of manual handling activities in nurses. We found an increased rate of correct manual handling in the post-intervention period.

[Risk factors for musculoskeletal complaints among microscope workers]. / Fattori di rischio per disturbi muscolo-scheletrici in lavoratori che utilizzano il microscopio.

OBJECTIVES: To describe the prevalence of musculoskeletal complaints among microscope workers, and to investigate the relationship between complaints in different body regions and individual as well work-related factors. METHODS: A detailed questionnaire on musculoskeletal symptoms was distributed to 176 microscope workers. The questionnaire contained questions on individual factors, workstation characteristics, work organization and psychosocial factors. RESULTS: The 1-month prevalence of symptoms at any body site was 76,1%. Symptoms were most commonly reported at the neck (53,4%), followed by the lower back (39,2%), upper back (23,9%), shoulders (21%), hand/wrist (21%) and arms (6,3%). Female gender was associated with complaints in all sites except low back. Hours of microscope use was associated with neck, arm and hand/wrist pain, whereas duration of work time without breaks was associated with neck, low back, and arm pain. Poor workstation ergonomics was associated with symptoms in the neck, shoulders, upper and lower back. Work pace was also identified as a risk factor for low back complaints. CONCLUSION: This study supports the need for ergonomic intervention at workplace and ergonomic training of microscope workers.

[Tobacco smoking among Italian physicians]. / Abitudine al fumo nei medici italiani.

A survey of the international literature published between 1985 and 2000 reveals high smoking rates among Italian physicians. Since 1985 smoking rates among physicians have gradually declined, similarly to those of general population. However, prevalence rates seem to vary between northern and southern Italy, with the highest rates in the southern regions. Studies examining smoking rates by gender reveal that, while smoking trends among males have declined somewhat, the latter remained relatively stable among female physicians. From an international perspective, declines in the absolute smoking rates of Italian physicians have not kept pace with those of many other countries, since at least one-quarter of Italian physicians currently smoke. Furthermore, most of the Italian physicians smoke while they are at work. This represents an occupational health problem that needs to be addressed by all levels of management. In meeting this challenge, occupational medicine has an important role to play in helping reduce the prevalence of smoking among health care workers.

[PC use in university students]. / Indagine sull'utilizzo del videoterminale in studenti universitari.

This study was aimed at investigating features related to PC use and prevalence of musculoskeletal symptoms among university students. A cross-sectional study was carried out among 98 university students. A questionnaire was used to collect data on personal characteristics, PC use and symptoms prevalence. Mean duration of daily PC use was 8,3 (DS 1,9) hours. The prevalences of neck, hand/wrist and shoulder pain in the previous month were 76%, 69% and 56% respectively. The findings of the present study suggest the needing of specific ergonomic training in university students.

[Assessment of radiofrequency electromagnetic fields levels in the Taranto area]. / Valutazione dei livelli di campo elettromagnetico a radiofrequenza nel territorio della Provincia di Taranto.

Radiofrequencies are extremely common in telecommunication sectors, in industry, in medicine and domestic applications. We carried out an observed study focusing on the punctual monitoring of the electromagnetic fields generated by mobile phones handsets or by SRB radiobase stations (transmitters), installed in Taranto and throughout the borough council. The measurement campaigns have been done by ARPA Puglia, Provincial Department of Taranto from November 2005 until March 2007, on 108 transmitting stations, of which 72 are of single installation and 36 of multiple installations, with UMTS, GSM. DCS, DVB-H kind of communication. The monitoring has been done with Wandel & Goltermann EMR-300 devices; the registered frequency is within the interval between 100 KHz and 3GHz and measures have been obtained with precise time interval of 6 minutes. In most of the monitored areas the results respected limit values; only in 2 cases on 108 the attention value has been exceeded, both within borough council area. In the town of Taranto values over 6 V/m fixed by the actual rule haven't been registered in none of the 51 monitored stations. We can, therefore, define within the limits the expositions emitted by the radiobase stations and in the buildings nearby the antennas.

[Job strain and blood pressure levels in health care workers]. / Job strain e pressione arteriosa in operatori sanitari.

OBJECTIVE: The aim of this study was to investigate a possible association between job strain and blood pressure levels in a sample of X-ray technologists. MATERIALS AND METHODS: A structured questionnaire S was administered to the participants, investigating individual factors and job characteristics. Job strain status was measured by means of questions derived from the Italian version of the Karasek Job Content Questionnaire. Systolic and diastolic blood pressure were then assessed during medical examination. RESULTS: No significant association was found between job strain and blood pressure levels. In addition, no association was found between high job demans, low decision latitude and blood pressure levels. CONCLUSIONS: In this study job strain was not associated with high blood pressure levels in X-ray technologists.

A novel Bluetongue virus serotype 3 strain in Tunisia, November 2016.

Since 1998, southern Europe has experienced multiple incursions of different serotypes and topotypes of Bluetongue virus, a vector-borne transmitted virus, the causative agent of Bluetongue (BT), a major disease of ruminants. Some of these incursions originated from northern Africa, likely because of wind-blown dissemination of infected midges. In this report, we describe the detection and whole genome characterization of a novel BTV-3 strain identified in a symptomatic sheep in Tunisia. Sequences were immediately deposited with the GenBank Database under Accession Nos KY432369-KY432378. Alert and preparedness are requested to face the next vector seasons in northern Africa and the potential incursion of this novel strain in southern Europe.

Usutu virus infections in humans: a retrospective analysis in the municipality of Modena, Italy.

OBJECTIVE: To monitor the spread and to evaluate the role for public health of Usutu virus (USUV) in an endemic area of Italy. METHODS: The survey was retrospectively conducted by detecting USUV RNA and USUV antibodies in cerebrospinal fluid and serum samples collected between 2008 and 2011 from 915 patients with or without neurologic impairments in the area of the municipality of Modena, Italy. Organs of birds and pools of mosquitoes were also tested for USUV RNA. Positive samples were partially sequenced and used for phylogenetic analysis. RESULTS: The presence of USUV RNA (1.1%; 95% confidence interval (CI) 0.6-2.0) was significantly (p <0.05) higher than that of West Nile virus (0%; 95% CI 0-0.33). USUV antibody level was 6.57% (95% CI 4.87-8.82), and it was significantly higher (p <0.05) compared to that of West Nile virus (p 2.96, 95% CI 1.89-4.62). Partial genome sequencing of USUV strains detected in humans, birds and mosquitoes revealed high nucleotide sequence identity within them and with the USUV strains isolated in Central Europe. CONCLUSIONS: USUV infection in humans is not a sporadic event in the studied area, and USUV neuroinvasiveness has been confirmed.