Chronic hookworm-related cutaneous larva migrans

Summary Objectives The purpose of this study is to present the 'chronic' or 'persistent' form of hookworm-related cutaneous larva migrans. Methods From 1998 to 2011, 13 patients were seen in our department with clinically typical hookworm-related cutaneous larva migrans that had been present for more than 5 months and that, because of the absence of pruritus, had never been treated. Results The duration of hookworm-related cutaneous larva migrans ranged from 5 to 14 months (mean 7.8 months) in these 13 patients (10 males and three females, aged 23–55 years). The infestation was acquired in Brazil (three patients), Jamaica (three patients), Mexico (two patients), Tanzania (two patients), Thailand (two patients), and Martinique (one patient). The infestation was located on the feet in 10 patients; one of these patients also presented tracks on the back and another presented tracks on a knee. The chest (two patients) and thigh (two patients) were also involved. All patients presented with clinically typical hookworm-related cutaneous larva migrans: seven patients had one track and six patients had two tracks. Laboratory and instrumental examinations were within the normal range or negative. Histopathological examination revealed edema in the papillary and upper dermis, and a perivascular and perifollicular infiltrate in the upper dermis, consisting mainly of lymphocytes and eosinophils. No larvae were detected. Conclusions This can be considered the 'chronic' or 'persistent' form of hookworm-related cutaneous larva migrans. Some pathogenetic hypotheses are suggested

The elderly and urban mobility: cost sensitivity of elderly people in the “oldest” Italian city

The world is facing a series of changes that will modify the way we envisage transport planning in our cities. Demographic ageing as a consequence of higher life expectancy and lower fertility rates is a world-wide phenomenon. While ageing is indeed a triumph of scientific progress and increasing longevity is perceived as one of humanity’s greatest achievements, the transition in society needs to be managed. In the urban context, any increase in age, health, and economic conditions determines one’s ability to enjoy the urban milieu and the so-called economies of urbanisation (advantages gained from an urban location, e.g., proximity to a market, labour supply, good communications, and financial and commercial services) longer. As there are more and more elderly people in cities, urban mobility becomes crucial in making the urban environment more inclusive. In order to provide suitable policy guidelines, it is, therefore, necessary to investigate and understand senior traveller behaviour.  In this study, we investigate urban travel characteristics of people aged 65 years and over living in the city of Genoa (one of the cities with the largest population of the elderly in the EU). By utilising a structured questionnaire, the paper explores the satisfaction and motivations of approx. 600 elderly public transport users in the city. In particular, exploratory factor analysis has been used to determine the key dimensions of the satisfaction and mobility motivations, and subsequently to use them to investigate the cost sensitivity of elderly people

Presencia del patrimonio cultural colonial hispánico-guaraní en el corredor del río Uruguay Estudio de caso: Franja costera entre Concepción del Uruguay y Concordia, provincia de Entre Ríos

Este proyecto plantea la investigación, evaluación, valoración, conservación y difusión del patrimonioarqueológico e histórico y su entorno como caso testigo de una tendencia mundial cada vez más afianzada: el estudio del patrimonio cultural y natural como una integridad.La hipótesis plantea que a lo largo del río Uruguay se encuentran una serie de construcciones realizadas en piedra y/o ladrillo en relación con antiguos caminos reales de carretas y de postas sobre una franja de cinco leguas paralela al río Uruguay en sus dos orillas.Se tomó, de manera arbitraria, la región comprendida entre Concordia y Concepción del Uruguay, en particular las localidades de San José, Ubajay y Pto. Yeruá, en la Provincia de Entre Ríos como muestra dentro de un universo mucho más amplio.Esta hipótesis inicial de proyecto de investigación ha sido ampliamente corroborada en los fondos documentales así como en los trabajos de campo realizados. Se ha concluido que al fortalecerseYapeyú como pueblo y centro económico de las misiones jesuíticas durante el período hispánico–guaraní en la costa del río Uruguay, los misioneros comienzan a descender hacia el sur bordeando el Uruguay medio, a lo largo de las dos costas, y a través de los ríos, estableciendo una red de postas, caleras, puestos, puertos y otros establecimientos productivos que comienzan a reportarse en los documentos de archivo a partir de 1747.La construcción de una analítica crítica de fuentes, documentos y cartografía, así como los estudios arqueológicos y arquitectónicos, realizados durante los trabajos de campo han permitido reconstruir conceptualmente la lógica territorial de ocupación del espacio del sistema jesuítico guaraní, entendiendo que cada sitio o conjunto de sitios signados en mapas, se relacionan con pasos del río habituales, redes de caminos, y construcciones como almacenes y otras para apoyar la navegación y el transporte de cargas.Estos hallazgos, en su primera etapa, revelarían que la provincia de Entre Ríos estaría integrada a un corredor cultural que la vincula históricamente con otros sitios de la región, en particular con el antiguo pueblo misionero de Yapeyú, Corrientes

Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows

With the introduction of direct-acting antiviral agents (DAA), the rate of sustained virological response (SVR) in the treatment of hepatitis C virus (HCV) has radically improved to over 95%. Robust scientific evidence supports a beneficial role of SVR after interferon therapy in the progression of cirrhosis, resulting in a decreased incidence of hepatocellular carcinoma (HCC). However, a debate on the impact of DAAs on the development of HCC is ongoing. This review aimed to analyse the scientific literature regarding the risk of HCC in terms of its recurrence and occurrence after the use of DAAs to eradicate HCV infection. Among 11 studies examining HCC occurrence, the de novo incidence rate ranged from 0 to 7.4% (maximum follow-up: 18 mo). Among 18 studies regarding HCC recurrence, the rate ranged from 0 to 54.4% (maximum "not well-defined" followup: 32 mo). This review highlights the major difficulties in interpreting data and reconciling the results of the included studies. These difficulties include heterogeneous cohorts, potential misclassifications of HCC prior to DAA therapy, the absence of an adequate control group, short follow-up times and different kinds of follow-up. Moreover, no clinical feature-based scoring system accounts for the molecular characteristics and pathobiology of the tumours. Nonetheless, this review does not suggest that there is a higher rate of de novo HCC occurrence or recurrence after DAA therapy in patients with previous HCV infection. \ua9 2018 The Author(s). Published by Baishideng Publishing Group Inc. All rights reserved

Preference for biological motion is reduced in ASD: implications for clinical trials and the search for biomarkers.

BACKGROUND: The neurocognitive mechanisms underlying autism spectrum disorder (ASD) remain unclear. Progress has been largely hampered by small sample sizes, variable age ranges and resulting inconsistent findings. There is a pressing need for large definitive studies to delineate the nature and extent of key case/control differences to direct research towards fruitful areas for future investigation. Here we focus on perception of biological motion, a promising index of social brain function which may be altered in ASD. In a large sample ranging from childhood to adulthood, we assess whether biological motion preference differs in ASD compared to neurotypical participants (NT), how differences are modulated by age and sex and whether they are associated with dimensional variation in concurrent or later symptomatology. METHODS: Eye-tracking data were collected from 486 6-to-30-year-old autistic (N = 282) and non-autistic control (N = 204) participants whilst they viewed 28 trials pairing biological (BM) and control (non-biological, CTRL) motion. Preference for the biological motion stimulus was calculated as (1) proportion looking time difference (BM-CTRL) and (2) peak look duration difference (BM-CTRL). RESULTS: The ASD group showed a present but weaker preference for biological motion than the NT group. The nature of the control stimulus modulated preference for biological motion in both groups. Biological motion preference did not vary with age, gender, or concurrent or prospective social communicative skill within the ASD group, although a lack of clear preference for either stimulus was associated with higher social-communicative symptoms at baseline. LIMITATIONS: The paired visual preference we used may underestimate preference for a stimulus in younger and lower IQ individuals. Our ASD group had a lower average IQ by approximately seven points. 18% of our sample was not analysed for various technical and behavioural reasons. CONCLUSIONS: Biological motion preference elicits small-to-medium-sized case-control effects, but individual differences do not strongly relate to core social autism associated symptomatology. We interpret this as an autistic difference (as opposed to a deficit) likely manifest in social brain regions. The extent to which this is an innate difference present from birth and central to the autistic phenotype, or the consequence of a life lived with ASD, is unclear