Natalizumab in Multiple Sclerosis: Long-Term Management

Natalizumab is a monoclonal antibody highly effective in the treatment of relapsing remitting multiple sclerosis (RRMS) patients. Despite its effectiveness, there are growing concerns regarding the risk of progressive multifocal leukoencephalopathy (PML), a brain infection caused by John Cunningham virus (JCV), particularly after 24 doses and in patients who previously received immunosuppressive drugs. Long-term natalizumab treated, immunosuppressive-pretreated, and JCV antibody-positive patients are asked to rediscuss natalizumab continuation or withdrawal after 24 doses. Until now, there has not been a clear strategy that should be followed to avoid PML risk and in parallel reduce clinical and radiological rebound activity. In this review, we analyzed the results of clinical trials and case reports in relation to the following situations: natalizumab continuation, natalizumab discontinuation followed by full therapeutic suspension or switch to other first or second line MS treatments. Quitting all MS treatment after natalizumab increases MS activity occurrence. The results regarding the therapeutic switch are not homogeneous, so at the moment there are no established guidelines regarding natalizumab treatment after 24 administrations; the choice is currently based on the professional experience of the neurologist, and on patients’ clinical features and preferences

La valutazione dell'efficacia dei contributi de minimis alle imprese: un approccio basato sul Regression Discontinuity Design

Questo lavoro espone i risultati di una valutazione di tipo controfattuale degli effetti degli aiuti de minimis a piccole imprese, sia nuove che esistenti, erogati in un comune della Sardegna. Le modalità di implementazione della politica e le caratteristiche dell’intervento indicano la metodologia del Fuzzy RD come quella più adatta in questo contesto. L’analisi è stata effettuata su un insieme di 174 imprese. I risultati indicano che, tra le imprese che hanno effettuato l’investimento con successo, l’impatto dell’intervento è stato positivo e significativo. Tuttavia, la variazione aggiuntiva dell’occupazione è limitata, circa 7 addetti in più. In generale, la presenza di un campione piccolo e del fenomeno della ubbidienza imperfetta suggeriscono di leggere questo risultato con cautela e non permettono di generalizzare il risultato per politiche simili applicate in ambito nazionale o regionale.This paper investigates the effect of a policy aimed at supporting small firms, the De Minimis aid Program, in the Italian region of Sardinia. Both the characteristics and the way the policy has been implemented suggest the use of the Fuzzy RD methodology as the most suitable in this context. The analysis is carried out on a group of 174 small firms. The results show that the impact of the program is positive and significant but only for one of three waves of the Program. Moreover, they also suggest that, in this case, the estimated additional variation in employment is small, approximately 7 additional employees. Overall, the presence of both small sample problems and imperfect compliance imply that the results may suffer from problems of limited external validity and should be read with caution

Les bains de Cefalà (Cefalà Diana, prov. de Palerme). Figures 1 à 5

Bagnera Alessandra, Di Liberto Rosa, Nef Annliese, Pezzini Elena. Les bains de Cefalà (Cefalà Diana, prov. de Palerme). Figures 1 à 5. In: Mélanges de l'École française de Rome. Moyen-Age, tome 117, n°2. 2005. pp. 1-5

Les bains de Cefalà (Cefalà Diana, prov. de Palerme) : la campagne de fouilles de septembre 2006

Bagnera Alessandra, Di Liberto Rosa, Nef Annliese, Pezzini Elena. Les bains de Cefalà (Cefalà Diana, prov. de Palerme) : la campagne de fouilles de septembre 2006. In: Mélanges de l'École française de Rome. Moyen-Age, tome 118, n°2. 2006. pp. 381-387

Les bains de Cefalà (Cefalà Diana, prov. de Palerme) : la campagne de fouilles de septembre 2005

Bagnera Alessandra, Di Liberto Rosa, Nef Annliese, Pezzini Elena. Les bains de Cefalà (Cefalà Diana, prov. de Palerme) : la campagne de fouilles de septembre 2005. In: Mélanges de l'École française de Rome. Moyen-Age, tome 117, n°2. 2005. pp. 781-791