Complementary medicine for alcohol dependence in Italian services: a mail questionnaire

It is well known that Complementary Medicine (CM) is extensively used in western countries for the treatment of many afflictions. CM has been recently promoted in addiction treatment. To evaluate CM use in alcohol dependence we planned a mail questionnaire for Italian alcohol services. We sent out 612 questionnaires. Health services that were unable to respond to the questionnaire within a 20-day limit period were contacted by phone and if we obtained agreement to participate in the study the questionnaire was sent by fax. We obtained 312 (51.82%) completed questionnaires. Only 16.50% of Italian services use CM for alcohol dependence treatment and acupuncture is utilized more frequently than other methods (phytotherapy, homeopathy, etc.). In Italian alcohol services CM is identified as an instrument incorporated into traditional alcohol treatments (self-help groups, drug treatment, etc.) and not an alternative method. In fact, health services that use it as a principal method of treatment were a rare event in our study (1%). CM plays an integrated role with traditional forms of alcohol treatment in Italian alcohol services and this utilization could be useful to reduce drop-outs and improve alcohol treatment compliance.     

A minD mutant of enterohemorrhagic E. coli O157:H7 has reduced adherence to human epithelial cells

Adherence to epithelial cells is a prerequisite for intestinal colonization by the bacterial pathogen, enterohemorrhagic Escherichia coli (EHEC). The deletion of minD, a cell division gene, in EHEC caused reduced adherence to human epithelioid cervical carcinoma (HeLa) and human colonic adenocarcinoma (Caco-2) cells as compared to wild-type. The minD mutant formed minicells and filaments owing to aberrant cytokinesis. Moreover, its ability to form microcolonies as typically seen in the co-cultures of wild-type with Caco-2 cells, was abolished. In conclusion, the present study highlights the importance of minD in regards to EHEC adherence to human epithelial cells.     

Compliance with yellow fever and measles vaccines in the revaccination program post-hematopoietic cell transplantation

Introduction

Measles, mumps, rubella, and even poliomyelitis outbreaks have recently perplexed infectious disease clinicians and epidemiologists globally due to the decline in vaccination coverage rates in children and adults. Measles and yellow fever (YF) have represented an increasing burden on the Brazilian public health system in recent decades. Both diseases are preventable by live-attenuated viral vaccines (LAVV), which have restricted use in hematopoietic cell transplant (HCT) recipients.

Methods

Autologous and allogeneic HCT recipients returning for regular appointments at the outpatient clinic were invited to participate in the study. Patients transplanted for at least 2 years and with a printed copy of the vaccination record were included.

Results

We assessed the vaccination records of 273 HCT recipients after the second year of HCT (193 allogeneic and 80 autologous) and observed lower compliance with the YF vaccine (58 patients, 21.2%) than with the measles vaccine (138 patients, 50.5%, p ≤ .0001). This is the largest published series of YF vaccination in HCT recipients so far. No severe adverse events occurred. Although expected, chronic graft-versus-host disease (GVHD) did not affect the compliance with measles (p = .08) or YF vaccination (p = .7). Indeed, more allogeneic recipients received measles vaccine in comparison with autologous patients (p < .0001), suggesting that chronic GVHD was not the main reason for not being vaccinated. Children and allogeneic HCT were more likely to receive measles vaccine. Time elapsed from HCT >5 years favored both measles and YF vaccination.

Conclusion

A better understanding of the reasons for low compliance with LAVV is necessary to overcome this problem.