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Immunological mechanisms involved in the genesis of the immune response against viral infections take into account the activation of both innate adaptative response. Innate immune defenses trigger a rapid local response, which is often sufficient to control viral infection, and promotes the subsequent activation of specific immune defenses. Natural killer (NK) cells that constitute a subpopulation of lymphocyte-related cells are a key factor of innate immune response and play a role in defense against viral infections by killing infected cells or by producing cytokines and interacting with adaptative immune system's cells. Killer immunoglobulin-like receptors (KIRs) regulate the activation of NK cells through their interaction with human leukocyte antigens (HLA). KIRs and HLA loci are highly polymorphic and certain HLA-KIRs combinations have been found to protect against viral infections. In this study we review how the KIRs/HLA repertoire may influence the course of hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV) and Herpes Simplex Virus 1 (HSV-1) infection. Results of our study suggest that a combination of KIRs/HLA gene/alleles is able to predict the outcome of viral infection and allows to plan successful customized therapeutic strategies.

Histoplasma capsulatum is an opportunistic dimorphic fungus responsible for most often self-limiting or flu-like infections but potentially lethal in immunocompromised hosts. Histoplasmosis is rare in Europe. We reported a case of disseminated histoplasmosis in an African HIV patient with a leprosy-like primary cutaneous presentation and involvement of lungs, brain, limphnodes and eye. The therapy with liposomial B amphotericin and itraconazole led to a prompt resolution of the symptoms.

Anthrax is a disease caused by Bacillus anthracis which affects herbivorous animals. Humans acquire the disease incidentally by exposure to infected animals, animal products or spores on soil. The infection is still endemic in many regions in developing countries. In Italy animal clusters are very rare and human cases are exceptional. Bacillus anthrax is also a potential source for acts of bioterrorism. In the natural human infection, cutaneous anthrax is the most widespread, while the other two, pulmonary and gastrointestinal anthrax, are very rare forms. We describe the first case of human anthrax occurring in western Sicily in the last twenty years. The cutaneous lesion healed without significant scarring after antibiotic treatment with tigecycline, rifampin and ciprofloxacin. Following our diagnosis, a cluster of bovine anthrax was detected in the district of Sciacca, causing the death of 13 animals. A larger outbreak was avoided by the vaccination of over 5000 herbivores.

Medical surveillance of Catania public sector employees who use video display terminals (VDTs) revealed complaints of eye and upper respiratory tract irritation, skin rash, headache, mental fatigue and reduced concentration in some of the workers. These were employed in three recently renovated offices and showed the above symptoms while at work. Investigations were performed to verify whether contaminants that may cause the above symptoms were present in the indoor air. In particular, levels of formaldehyde and CO2 were continuously monitored. CO2 levels were found to be higher in offices open to the general public as compared to other offices (including the three renovated ones). However, CO2 levels were never above 1,000 ppm. Formaldehyde was found in the indoor air of all three renovated offices in approximately equal concentrations, ranging from a minimum of 0,07 - 0,09 ppm to a maximum of 0,3 -0,4 ppm. In addition, a strong pungent odor typical of this substance was present in all three renovated offices but not in the others. Formaldehyde pollution must always be considered and assessed whenever new furnishings that may have required the use of glues that emit formaldehyde are brought into an indoor environment.

Aim: to estimate the prevalence of HBV positivity considering the qualifications of workers exposed to biological risk in a hospital in Eastern Sicily., Subjects and Method: 1800 people exposed to biological risk: surgeons, physicians, laboratory workers, rehabilitation therapists, midwives, biologists and technicians underwent a test for HBV., Results: 25 workers resulted positive to HBsAg, that is 1.3 % of the total population examined; the professional categories mostly resulting positive were the auxiliaries with a 2% prevalence, and professional nurses with 1.5%, followed by surgeons resulting 1% positive. In the positive group of HBsAg, 16 workers, equal to 64%, were also positive to the viral replication test. Regarding the antibody coverage, the distribution among workers evidenced that 30.4% of the nurses was vaccinated, against 15% of the surgeons and 11.7% of the physicians. 6.4% of the total population studied had a natural immunity, with an absolute prevalence in the auxiliary group-OTA: 9.3%, followed by the professional nurses with a 7.8% positivity., Conclusion: it is shown that the health care workers do not have a sufficient perception of the biological risk, so it is necessary to adopt new strategies to promote the vaccination and increase formation activities and general information.