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The purpose of this investigation was to determine how specialists in paediatric infectious diseases (PIDs) manage children with suspected Lyme disease (LD) by comparing their approaches in Italian endemic and non-endemic areas. A cross-sectional survey of the PID specialists participating in the Italian Society for Pediatric Infectious Disease (SITIP) Registry of LD was carried out between 1 January and 30 April 2012. A total of 160 children (80 living in endemic areas and 80 living in non-endemic areas) were diagnosed as having LD between 1 January 2005 and 31 December 2011. The clinical manifestations were erythema migrans in 130 cases (81.3 %), arthritis in 24 (15.0 %) and neuroborreliosis in six (3.8 %). Significant differences from the recommendations concerning serology and the tests to undertake were mainly observed in the children with erythema migrans, especially those living in non-endemic areas ( p < 0.05). The children with erythema migrans who lived in non-endemic areas were treated with antibiotics significantly less frequently than those living in endemic areas ( p < 0.05), and significantly fewer children with erythema migrans or arthritis living in non-endemic areas were treated with amoxicillin in comparison with those living in endemic regions ( p < 0.05). The duration of antimicrobial therapy was significantly shorter than recommended in the children with erythema migrans or arthritis, especially those living in non-endemic areas ( p < 0.05). Paediatric LD is also present in areas of Italy in which it is not considered endemic, but knowledge concerning its management is generally poor among PID specialists and characterised by enormous gaps in non-endemic areas. [ABSTRACT FROM AUTHOR]

The many recent researches into the mysterious disappearance of Ettore Majorana, one of the greatest minds of theoretical physics in the twentieth century, are summarised and discussed in some detail. The fate of the Italian scientist is argued to be intimately related to the final months of his life in Naples, from where he decided to disappear in March 1938. This analysis of accurate and detailed investigations performed in the last few years, together with facts already known, reveals a fascinating and intriguing picture, which was previously unexpected. New light on the disappearance of Majorana, a mystery that has lasted for more than 70 years, then emerges. [ABSTRACT FROM AUTHOR]

Aims To conduct a multicentre observational study to describe management of foot infections in diabetes in the out-patient setting in Italy. Patients and methods Ten centres equally distributed nationwide were asked to collect, by means of a spreadsheet (Access/Excel Microsoft program), data concerning 30 consecutive diabetic patients with foot infections deemed suitable for antibiotic treatment in the out-patient setting. Centres with ≥ 5 years’ experience of out-patient management were selected. Data from 271 consecutive patients treated as out-patients were collected and analysed by the central coordinator. Statistical analysis was performed using the SPSS statistical software package. Results Lesions were mainly located at the toes and midfoot (33.6 and 30.2%, respectively); 63 (23.2%) patients had multiple ulcers. Seventy (25.8%) patients also had concomitant osteomyelitis. Three hundred and four pathogens, including Gram-positive and Gram-negative aerobes and anaerobes, were isolated in 219/271 patients (80.8%) by culturing debrided tissue (71.2%) or purulent material (28.8%). Infections were polymicrobial in 33.8% of patients. The most common pathogens were Staphylococcus aureus (27.3%) and Pseudomonas spp. (20.4%); enterobacteriaceae, enterococci, streptococci and anaerobes accounted for 11.5, 7.6, 6.9 and 1.9%, respectively. Antibiotics were frequently administered by parenteral route and frequently in combination. Piperacillin/tazobactam was the parenteral antibiotic most frequently utilized (21.1%). Cure/improvement was observed in 93.4% of patients. Conclusions Foot ulcers in diabetes are common and serious; the aetiology is often polymicrobial, often including S. aureus and Pseudomonas spp. Treatment in the out-patient setting is safe and effective, and penicillins together with β-lactamase inhibitors and fluoroquinolones are the most frequent choice. [ABSTRACT FROM AUTHOR]

This work presents a functional clustering procedure applied to meteorological time series. Our proposal combines time series interpolation with smoothing penalized B-spline and the partitioning around medoids clustering algorithm. Our final goal is to obtain homogeneous climate zones of Italy. We compare this approach to standard methods based on a combination of principal component analysis and Cluster Analysis (CA) and we discuss it in relation to other functional clustering approaches based on Fourier analysis and CA. We show that a functional approach is simpler than the standard methods from a methodological and interpretability point of view. Indeed, it becomes natural to find a clear connection between mathematical results and physical variability mechanisms. We discuss how the choice of the basis expansion (splines, Fourier) affects the analysis and propose some comments on their use. The basis for classification is formed by monthly values of temperature and precipitation recorded during the period 1971-2000 over 95 and 94 Italian monitoring stations, respectively. An assessment based on climatic patterns is presented to prove the consistency of the clustering and a comparison of results obtained with different methods is used to judge the functional data approach. [ABSTRACT FROM AUTHOR]

Objectives Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy. Patients and methods During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively. Results Macrolide resistance genotypes were detected in 11 (26%) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes. Conclusions This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe. [ABSTRACT FROM PUBLISHER]

Diaporthe helianthi is the causal agent of a severe sunflower disease but, in Italy, disease outbreaks are sporadic with no significant losses. The present work investigates the role of meteorological conditions on the potential development of D. helianthi epidemics in Italy, using the French model Asphodel, which simulates the effect of air temperature, relative humidity and rainfall on ascospore maturation and dispersal, infection establishment, disease onset and severity during the period of host susceptibility. Meteorological data measured in eight stations distributed from north to south Italy, over a 5-year period (1995–99), was used as model input. Results showed that meteorological conditions in Italy are frequently favourable for D. helianthi infections on sunflower, and severe epidemics are possible. Therefore, climatic conditions are not a limiting factor for disease development in the Italian sunflower-growing areas. The lack of disease epidemics in Italy may be related to differences in the pathogen populations compared with the French ones. [ABSTRACT FROM AUTHOR]