Anaphylaxis induced by intramuscular betamethasone disodium phosphate: reflections on a clinical case.

Glucocorticoids could be responsible for allergic symptoms correlated to an Ig-E mediated hypersensitivity mechanism. We describe the case of an anaphylactic reaction in a professional nurse, occurring after an intramuscular administration of Betamethasone. After performing skin prick tests, intramuscular tests and patch tests we concluded that the patient had Ig-E mediated sensitization. She was prescribed oral Prednisone and Deflazacort and shows good tolerance of these drugs. This demonstrates that in these patients it is possible to administrate glucocorticoids without the changes in the sites indicated by Wilkinson. Nevertheless, our patient showed a negative allergy test for Dexamethasone disodium phosphate, and in those patients sensitized to fluorinated glucocorticoids, tolerance to other glucocorticoids is not so easily predictable as in patients with hypersensitivity to first generation steroids or in corticosteroid contact dermatitis, according to the four patterns of cross-reactivity proposed by Coopman and Dooms-Goossens.

Epidemiological and virological assessment of influenza activity in Apulia, Italy, during the seasons 2004 - 2005 and 2005 - 2006.

This study evaluated the impact of influenza and vaccination coverage in Apulia, Italy, during the 2004 - 2005 and 2005 - 2006 seasons, using epidemiological and virological surveillance data collected through the Italian Net of Surveillance of Influenza (InfluNet) organized by the Superior Institute of Health (ISS) and the Inter-University Centre of Research on Influenza (CIRI). Vaccination coverage was calculated from the number of doses administered to individuals aged >or= 65 years. Sentinel physicians reported weekly influenza-like illness (ILI) and acute respiratory illness (ARI) occurrences among patients. Influenza viruses were isolated and identified by cell culture on Madin-Darby Canine Kidney cells and polymerase chain reaction techniques. Vaccination coverage reached 72.7% and 77.0% during the 2004 - 2005 and 2005 - 2006 seasons, respectively. Incidence of ILI was higher during the 2004 - 2005 season compared with the 2005 - 2006 season, whereas the incidence ARI appeared to show a more constant trend. Incidence rates for ILI and ARI were higher in the 0 - 14-year age group. The increase in vaccination coverage and implementation of a network of epidemiological and virological surveillance are fundamental for the control and prevention of influenza.

Myiasis of the tracheostomy wound: case report.

"Myiasis" is a parasitic infestation of live human or vertebrate animal tissues or cavities caused by dipterous larvae (maggots) which feed on the host's dead or living tissue, liquid body substances or ingested food. They are extremely rare in Western countries, especially in E.N.T. practice, and to the best of our knowledge, only two cases of myiasis in a tracheostomy wound have been reported in the English literature. The case is reported, probably the first, of percutaneous tracheotomy myiasis. It was caused by infestation with larvae of Lucilia Caesar. The patient had undergone Griggs percutaneous tracheostomy 3 years earlier and was in a persistent vegetative state on account of a pontomesencephalic haemorrhage but maintained spontaneous breathing. The condition was treated by applying ether to the tracheotomy wound, which caused spontaneous exit of approximately 30 larvae, easily removed with forceps. The laboratory microbiologist observed and photographed macroscopic and microscopic characters of the larvae, of primary importance for species diagnosis. Predisposing factors could be: 1. smaller dimension of percutaneous tracheostomy in comparison to surgical tracheostomy; 2. vegetative state of patient; 3. poor hygiene of outer and inner tube; 4. bad smell of wound, which attracts flies; 5. living in a rural area. Although this is not a lethal disorder, knowledge of the disease is necessary from the preventive, diagnostic and curative standpoint. It is important to proceed with identification of the larvae, distinguishing them from other types of myiasis involving different therapeutic implications. Ecology, classification, and treatment of myiasis are reviewed.

PBMCs protein expression profile in relapsing IFN-treated multiple sclerosis: A pilot study on relation to clinical findings and brain atrophy.

This cross-sectional study investigated with two-dimensional gel electrophoresis coupled to MALDI-TOF and MRI the relationship between PBMCs protein expression profile and whole-brain atrophy in 16 unselected RR-MS IFN-treated patients compared with 6 RR IFN-untreated and 12 matched healthy control subjects. Grey/white matter fraction, T1/T2 lesion load and clinical variables were considered too. Twenty six proteins showed significant differential expression among RR IFN-treated patients and control samples. Four of these (IN35, GANAB, PP1B, SEPT2) resulted correlated with clinical and MRI findings in RR IFN-treated MS patients. Future clinical applications remain to be validated by other techniques and confirmed by a larger study.