Severe anaemia after gastric biopsy in an infant with eosinophilic gastritis

Background: Eosinophilic gastrointestinal disorders (EGID) are characterized by eosinophilic inflammation and are subclassified according to the affected site(s) as eosinophilic esophagitis, eosinophilic gastritis, eosinophilic enteritis and eosinophilic colitis. Clinical presentation includes dyspeptic symptoms, vomiting, abdominal pain, diarrhoea and gastrointestinal bleeding. Peripheral eosinophilia is usually found but is not required for the diagnosis. The treatment is based on dietary elimination therapy, consisting of removal of common food triggers, most frequently cow's milk in infants. Corticosteroids are used as first line drug therapy in EG if dietary therapy fails to achieve an adequate clinical response or is impractical. Case presentation: A four month old infant was admitted for an episode of melena and hematemesis. An esophagogastroduodenoscopy showed haemorrhagic gastritis with ulcerative lesions and fibrin. A significant gastric bleeding was noted after the procedure. The gastric mucosa biopsies showed an eosinophilic infiltration. Conclusions: A clinically relevant anaemia is a quite rare complication in infants with eosinophilic gastritis and a biopsy may worsen bleeding, to a potentially severe level of low haemoglobin. In infants with low haemoglobin levels and suspect eosinophilic gastritis a watchful follow up after the biopsy should be considered, as well as the possibility of postponing the biopsy to reduce the bleeding risk

Monitoring soil wetness variations by means of satellite passive microwave observations: the HYDROPTIMET study cases

International audienceSoil moisture is an important component of the hydrological cycle. In the framework of modern flood warning systems, the knowledge of soil moisture is crucial, due to the influence on the soil response in terms of infiltration-runoff. Precipitation-runoff processes, in fact, are related to catchment's hydrological conditions before the precipitation. Thus, an estimation of these conditions is of significant importance to improve the reliability of flood warning systems. Combining such information with other weather-related satellite products (i.e. rain rate estimation) might represent a useful exercise in order to improve our capability to handle (and possibly mitigate or prevent) hydro-geological hazards. Remote sensing, in the last few years, has supported several techniques for soil moisture/wetness monitoring. Most of the satellite-based techniques use microwave data, thanks to the all-weather and all-time capability of these data, as well as to their high sensitivity to water content in the soil. On the other hand, microwave data are unfortunately highly affected by the presence of surface roughness or vegetation coverage within the instantaneous satellite field of view (IFOV). Those problems, consequently, strongly limit the efficiency and the reliability of traditional satellite techniques. Recently, using data coming from AMSU (Advanced Microwave Sounding Unit), flying aboard NOAA (National Oceanic and Atmospheric Administration) satellites, a new methodology for soil wetness estimation has been proposed. The proposed index, called Soil Wetness Variation Index (SWVI), developed by a multi-temporal analysis of AMSU records, seems able to reduce the problems related to vegetation and/or roughness effects. Such an approach has been tested, with promising results, on the analysis of some flooding events which occurred in Europe in the past. In this study, results achieved for the HYDROPTIMET test cases will be analysed and discussed in detail. This analysis allows us to evaluate the reliability and the efficiency of the proposed technique in identifying different amounts of soil wetness variations in different observational conditions. In particular, the proposed indicator was able to document the actual effects of meteorological events, in terms of space-time evolution of soil wetness changes, for all the analysed HYDROPTIMET test cases. Moreover, in some circumstances, the SWVI was able to identify the presence of a sort of "early" signal in terms of soil wetness variations, which may be regarded as a timely indication of an anomalous value of soil water content. This evidence suggests the opportunity to use such an index in the pre-operational phases of the modern flood warning systems, in order to improve their forecast capabilities and their reliability

Assessing the potential of <i>SWVI</i> (Soil Wetness Variation Index) for hydrological risk monitoring by means of satellite microwave observations

International audienceIn the last years satellite remote sensing applications in hydrology have considerably progressed. A new multi-temporal satellite data-analysis approach has been recently suggested in order to estimate space-time changes of geophysical parameters possibly related to the increase of environmental and hydro-geological hazards. Such an approach has been already used both for flooded area mapping (using AVHRR data) and for soil wetness index estimation (using AMSU data). In this work, a preliminary sensitivity analysis of the proposed Soil Wetness Variation Index (SWVI) is made in the case of low intensity meteorological events by the comparison with hydrological (precipitation) data. This analysis, as a first step of a more complex work in progress, is targeted to a first evaluation of the reliability of the SWVI in describing soil response to precipitations of different duration and intensity

Monitoring soil wetness variations by means of satellite passive microwave observations: the HYDROPTIMET study cases

Soil moisture is an important component of the hydrological cycle. In the framework of modern flood warning systems, the knowledge of soil moisture is crucial, due to the influence on the soil response in terms of infiltration-runoff. Precipitation-runoff processes, in fact, are related to catchment's hydrological conditions before the precipitation. Thus, an estimation of these conditions is of significant importance to improve the reliability of flood warning systems. Combining such information with other weather-related satellite products (i.e. rain rate estimation) might represent a useful exercise in order to improve our capability to handle (and possibly mitigate or prevent) hydro-geological hazards. <P style='line-height: 20px;'> Remote sensing, in the last few years, has supported several techniques for soil moisture/wetness monitoring. Most of the satellite-based techniques use microwave data, thanks to the all-weather and all-time capability of these data, as well as to their high sensitivity to water content in the soil. On the other hand, microwave data are unfortunately highly affected by the presence of surface roughness or vegetation coverage within the instantaneous satellite field of view (IFOV). Those problems, consequently, strongly limit the efficiency and the reliability of traditional satellite techniques. <P style='line-height: 20px;'> Recently, using data coming from AMSU (Advanced Microwave Sounding Unit), flying aboard NOAA (National Oceanic and Atmospheric Administration) satellites, a new methodology for soil wetness estimation has been proposed. The proposed index, called Soil Wetness Variation Index (<I>SWVI</I>), developed by a multi-temporal analysis of AMSU records, seems able to reduce the problems related to vegetation and/or roughness effects. Such an approach has been tested, with promising results, on the analysis of some flooding events which occurred in Europe in the past. <P style='line-height: 20px;'> In this study, results achieved for the HYDROPTIMET test cases will be analysed and discussed in detail. This analysis allows us to evaluate the reliability and the efficiency of the proposed technique in identifying different amounts of soil wetness variations in different observational conditions. In particular, the proposed indicator was able to document the actual effects of meteorological events, in terms of space-time evolution of soil wetness changes, for all the analysed HYDROPTIMET test cases. Moreover, in some circumstances, the <I>SWVI</I> was able to identify the presence of a sort of 'early' signal in terms of soil wetness variations, which may be regarded as a timely indication of an anomalous value of soil water content. This evidence suggests the opportunity to use such an index in the pre-operational phases of the modern flood warning systems, in order to improve their forecast capabilities and their reliability

Efficacy of dupilumab in atopic comorbidities associated with moderate-to-severe adult atopic dermatitis

Background: Dupilumab is an anti-IL-4Rα antibody used in the treatment of patients with moderate-to-severe atopic dermatitis (msAD). This study explored the potential benefit of dupilumab in perennial allergic rhinoconjunctivitis (PAR) and perennial allergic asthma (PAA) caused by indoor allergens in adults with msAD. Methods: This multicentric, prospective, observational, real-life study included adult patients with msAD who had been treated with dupilumab in 16 Italian care centres. Efficacy outcomes regarding AD, PAR and PAA were collected at baseline and 16&nbsp;weeks. Safety was also assessed. Results: We enrolled 123 patients with msAD. Between baseline and 16&nbsp;weeks of treatment, the following measurements decreased statistically significantly: Eczema Area and Severity Index, SCOring AD, Patient-Oriented Eczema Measure, pruritus score, sleep score, Dermatology Life Quality Index and IgE. Dupilumab treatment in patients with comorbid PAR (n&nbsp;=&nbsp;41) was associated with significant improvements in PAR disease control (measured using a Rhinitis Control Scoring System) and in PAR Quality of life (QoL) (measured using the Rhinoconjunctivitis QoL Questionnaire scores). In 32 patients with comorbid PAA, dupilumab significantly improved PAA control (measured using the Asthma Control Test and five-item Asthma Control Questionnaire scores) and disease-related QoL (measured using the Asthma QoL Questionnaire scores). Thirty-five patients (28.5%) developed conjunctivitis during the study period. Conclusion: These results support the benefits of dupilumab for adult patients with PAR and/or PAA associated with msAD

QUADRUPLE RESCUE THERAPY AFTER FIRST AND SECOND LINE FAILURE FOR HELICOBACTER PYLORI TREATMENT: COMPARISON BETWEEN TWO TETRACYCLINE-BASED REGIMENS

Background &amp; Aims: Antibiotic resistance is the main reason for failure of Helicobacter pylori (H. pylori) treatment. Currently, guidelines recommend a treatment guided by antimicrobial susceptibility testing after two failures. However, microbial culture is not feasible everywhere, and the limited number of effective antibiotics against the bacterium narrows the options; thus a rescue therapy combining antibiotics with a low resistance may be fitting. Methods: Patients who have failed a first-line treatment (either prolonged triple or sequential regimens) and, successively, a levofoxacin-based triple therapy were considered for the study. Subjects underwent urea breath test (UBT), stool antigen test (ST) and endoscopy/histology to confirm the diagnosis. Cytopenia and impaired liver and kidney function were exclusion criteria. Fify-four subjects were randomized 1:1 to two regimens: RMB abeprazole/Rifabutin/Minocycline/Bismuth sub-citrate or MTB Rabeprazole/Tinidazole/ Minocycline/Bismuth sub-citrate both for 10 days. Te results were checked 6 weeks afer the end of therapy with ST/UBT plus endoscopy when indicated. Results: RMB eradicated the bacterium in 21 patients. Two subjects dropped out. Te eradication rate was 77.7% (CI 62.0-93.4%) at intention-to-treat and 84.0% (CI 69.6-98.4%) at per-protocol analysis. MTB was successful in 14 patients (51.9%, CI 33.1-70.7%). No patient withdrew from the treatment for adverse events. Drug-related side effects were reported only in 3 subjects, but in all cases the treatment was carried on. Conclusions: Te association minocycline/rifabutin seems to have a synergic effect and a good therapeutic outcome in patients who have failed at least two previous regimens, although a trial on a large population is needed

Cancer patients and telenursing interventions in Italy. a systematic review

Objective: The use of digital technologies could improve patients’ quality of care, satisfaction, and health-related outcomes in cancer patients. This paper aims to explore the use of digital technologies in nursing management of cancer patients in Italy. Patients and Methods: A systematic literature review was performed. PubMed, Excerpta Medica dataBASE (Embase), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Library databases were consulted from September 1, 2021, to January 31, 2022. Key terms for Telenurs-ing/Telemedicine and cancer in Italy were used. The quality of each study was assessed through the Grading of Recommendations, Assessment, Development, and Evaluations method. Results: 131 articles were found and 5 were included: two randomized-clinical-trial protocols aimed to explore the impact of medication management apps on patients’ quality of life; one validation trial suggested good reliability in the therapeutic adherence of patients on chemotherapy but limited sensitivity in detecting related adverse events; two observational studies described the validation of telephone triage prehospitalization programs performed by nurses during the pandemic. Conclusions: The use of digital technologies in nursing management of cancer patients is in-frequent in Italy, however, increased during the pandemic. Further studies are needed to evaluate the impact and effectiveness of the use of digital technologies in nursing management in cancer patients

HER2 Overexpression and Cytogenetical Patterns in Canine Mammary Carcinomas

Human epidermal growth factor receptor 2 (HER2) is a tyrosine kinase receptor that promotes tumor cell growth and is implicated in the pathogenesis of human breast cancer. The role of HER2 in canine mammary carcinomas (CMCs) is not clear. Therefore, this study aimed to examine the protein expression and cytogenetic changes of HER2 and their correlation with other clinical-pathological parameters in CMC. We retrospectively selected 112 CMCs. HER2, ER, and Ki67 were assessed by immunohistochemistry. HER2 antibody validation was investigated by immunoblot on mammary tumor cell lines. Fluorescence in situ hybridization (FISH) was performed with probes for HER2 and CRYBA1 (control gene present on CFA9). HER2 protein overexpression was detected in 15 carcinomas (13.5%). A total of 90 carcinomas were considered technically adequate by FISH, and 8 out of 90 CMC (10%) were HER2 amplified, 3 of which showed a cluster-type pattern. HER2 overexpression was correlated with an increased number of HER2 gene copies (p = 0.01; R = 0.24) and overall survival (p = 0.03), but no correlation with ER, Ki67, grade, metastases, and tumor-specific survival was found. Surprisingly, co-amplification or polysomy was identified in three tumors, characterized by an increased copy number of both HER2 and CRYBA1. A morphological translocation-fusion pattern was recognized in 20 carcinomas (22%), with a co-localized signal of HER2 and CRYBA1. HER2 is not associated with clinical-pathological parameters of increased malignancy in canine mammary tumors, but it is suitable for studying different amplification patterns