Oral HPV infection and MHC class II deficiency (A study of two cases with atypical outcome)

<p>Abstract</p> <p>Background</p> <p>Major histocompatibility complex class II deficiency, also referred to as bare lymphocyte syndrome is a rare primary Immunodeficiency disorder characterized by a profondly deficient human leukocyte antigen class II expression and a lack of cellular and humoral immune responses to foreign antigens. Clinical manifestations include extreme susceptibility to viral, bacterial, and fungal infections. The infections begin in the first year of life and involve usually the respiratory system and the gastrointestinal tract. Severe malabsorption with failure to thrive ensues, often leading to death in early childhood. Bone marrow transplantation is the curative treatment.</p> <p>Case reports</p> <p>Here we report two cases with a late outcome MHC class II deficiency. They had a long term history of recurrent bronchopulmonary and gastrointestinal infections. Bone marrow transplantation could not be performed because no compatible donor had been identified. At the age of 12 years, they developed oral papillomatous lesions related to HPV (human papillomavirus). The diagnosis of HPV infection was done by histological examination. HPV typing performed on the tissue obtained at biopsy showed HPV type 6. The lesions were partially removed after two months of laser treatment.</p> <p>Conclusions</p> <p>Viral infections are common in patients with MHC class II and remain the main cause of death. Besides warts caused by HPV infection do not exhibit a propensity for malignant transformation; they can cause great psychosocial morbidity.</p

Cultural approach to healthcare risk management An Italian experience with LASA (look-alike, sound-alike) drugs

Risk management is fundamental in healthcare organisations at both the institutional (organisations) and sectorial (health) levels, not only as an operational technique but also as part of a managerial model. Thus, it is essential to highlight the strategic importance of the cultural impact, both clinically and financially, of correct risk integration between professional and organisational functioning. This research presents a case study of the Casa di Cura Tortorella S.p.a. (Salerno, Italy), which adopted a unique solution to handle logistical risks concerning medicines that have the potential to lead to dangerous confusions due to their similar names, dosages, packaging, and other elements (i.e., look-alike, sound-alike [LASA] drugs). Using the case study technique, the investigation highlights that the adoption of an operational mechanism for risk management, although useful, is limited if it is not supported by thorough training (for every operator) and a new organisational and cultural role, i.e., ‘nursing team leaders’, with responsibility for coordination and reporting, and has direct and indirect impacts on the financial performance of healthcare organisations

Ownership structure and technological innovation: an investigation of Tunisian agri-food companies

Purpose - The aim of this study is to investigate potential relationships between the corporate governance system and the innovation development process, with a specific focus on the agri-food sector in the Tunisian context.Design/methodology/approach - Most studies on innovation management have shown the collective nature of the innovation process, resulting from the multiple interactions that can be established between various actors, internal and external to the enterprise perimeter, which is increasingly digitally open, especially in the COVID-19 era. More specifically, the implementation of an innovation strategy is a risky issue for businesses, most of all when considering its financial requirements and impacts, and thus, appropriate management plays a relevant role in this respect.Findings - Statistical tests, operated on a sample of 80 Tunisian companies, show that the style of management and the concentration of ownership exert significant influence on the dynamism of technological innovation in the agri-food sector.Originality/value - The involvement and the commitment of institutional investors can contribute to stimulate the innovation process in the agri-food sector, providing related implications with significant impact, at the scientific and managerial level