Disseminated superficial porokeratosis and pyoderma gangrenosus

Disseminated Superficial Actinic Porokeratosis (DSAP) is usually triggered by sun exposure. In some cases sun exposure is not essential and this skin disease is related to immunosuppression. Many associated diseases are described in the literature. We report a clinical case of a patient affected by pyoderma gangrenosum, who developed DSAP

The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era

Background: Erythema migrans (EM) is the hallmark manifestation of the Lyme borreliosis (LB), and therefore its presence and recognition are sufficient to make a diagnosis and to start proper antibiotic treatment to attempt to eradicate the infection. Methods: In this study we compared the clinical data of 439 patients who presented an EM either according to the diagnostic modality through physical assessment or through telemedicine. Conclusions: Our data clearly show that telemedicine for EM diagnosis is useful as it enables prompt administration of appropriate antibiotic therapy, which is critical to avoid complications, especially for neurologic and articular entities. Therefore, telemedicine is a tool that could be adopted for the diagnosis of Lyme disease both by specialized centers but also by general practitioners

Improving the early diagnosis of early nodular melanoma: can we do better?

Introduction: Cutaneous melanoma is the sixth most common malignant cancer in the USA. Among different subtypes of melanoma, nodular melanoma (NM) accounts about 14% of all cases but is responsible for more than 40% of melanoma deaths. Early diagnosis is the best method to improve melanoma prognosis. Unfortunately, early diagnosis of NM is particularly challenging given that patients often lack identifiable risk factors such as many moles or freckles. Moreover, early NM may mimic a range of benign skin lesions that are not routinely excised or biopsied in every day practice. For this reason, specific clinical and skin imaging clues have been proposed to improve early detection of NM.Areas covered: The review discusses about the noninvasive tools to diagnose thin melanoma, particularly NM. Expert commentary: Currently, dermatologists present a wide opportunity of diagnostic tools. Current data suggest that the early diagnosis of NM is a major challenge as the majority of early NM are symmetric, roundish, and lack specific pattern. Another promising strategy is based on recent data suggesting that artificial intelligence based on deep convolutional neural networking is able to outperform average dermatologist. Further research is necessary to validate the performance of this method in the real world and in the clinical setting

Gene Therapy for Mitochondrial Diseases: Current Status and Future Perspective

Mitochondrial diseases (MDs) are a group of severe genetic disorders caused by mutations in the nuclear or mitochondrial genome encoding proteins involved in the oxidative phosphorylation (OXPHOS) system. MDs have a wide range of symptoms, ranging from organ-specific to multisystemic dysfunctions, with different clinical outcomes. The lack of natural history information, the limits of currently available preclinical models, and the wide range of phenotypic presentations seen in MD patients have all hampered the development of effective therapies. The growing number of pre-clinical and clinical trials over the last decade has shown that gene therapy is a viable precision medicine option for treating MD. However, several obstacles must be overcome, including vector design, targeted tissue tropism and efficient delivery, transgene expression, and immunotoxicity. This manuscript offers a comprehensive overview of the state of the art of gene therapy in MD, addressing the main challenges, the most feasible solutions, and the future perspectives of the field

Parry-Romberg syndrome: A case with a possible association with lyme disease

Parry-Romberg syndrome is an acquired slowly progressive disease characterized by an atrophy mostly involving half of the face. The pathogenesis of this disfiguring condition is still controversial. The relationship between Parry-Romberg syndrome and Lyme disease needs to be considered in depth. A 16-year-old woman from Albania presented with linear depressions of the right side of the face, clinically compatible with Parry-Romberg syndrome. She had a positive history of Lyme disease. Borrelia infection was confirmed by the positivity of PCR and the presence of IgM antibodies. The patient received intravenous penicillin and metronidazole for 14 days. After treatment and during a 2-year follow-up, the clinical disease progression was halted and the serological and microbiological tests for Borrelia burgdorferi sensu lato were negative. We cannot exclude a coincidence, however, of the bacteriological and serological evidence. Moreover, the interruption of the disease progression after the antibiotic therapy is difficult to ignore without claiming that this association is at least suggestive

Abdominopelvic post-irradiation morphea in a prostate cancer patient: the first case of an under recognized condition

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The GAP-TPC

Several experiments have been conducted worldwide, with the goal of observing low-energy nuclear recoils induced by WIMPs scattering off target nuclei in ultra-sensitive, low-background detectors. In the last few decades noble liquid detectors designed to search for dark matter in the form of WIMPs have been extremely successful in improving their sensitivities and setting the best limits. One of the crucial problems to be faced for the development of large size (multi ton-scale) liquid argon experiments is the lack of reliable and low background cryogenic PMTs: their intrinsic radioactivity, cost, and borderline performance at 87 K rule them out as a possible candidate for photosensors. We propose a brand new concept of liquid argon-based detector for direct dark matter search: the Geiger-mode Avalanche Photodiode Time Projection Chamber (GAP-TPC) optimized in terms of residual radioactivity of the photosensors, energy and spatial resolution, light and charge collection efficiencyComment: 7 pages, 5 figures, Accepted for publication on JINS

A tool for evaluating geothermal power exploitability and its application to Ischia, Southern Italy

The paper proposes a method to evaluate the potential for electric power production at any site of possible geothermal interest. Accounting for geological data of the reservoirs, the method allows the computation of the available electrical power of the investigated site. Electrical energy production from geothermal sources is realized through different techniques, such as single flash and double flash, dry steam, and binary ORC plants. The technique chosen to be the most productive is determined by analyzing a specific range of geofluid properties, mainly temperature and pressure. Moreover, each plant typology has a global efficiency that may be correlated to geofluid enthalpy by empiric relations available in literature. The proposed evaluation method brings together all these correlations, yielding the power availability from a geosource, once its temperature and pressure are known. The method takes as input the geofluid available flow rate, its pressure, temperature and non-condensable gas content. It defines the best plant option from these parameters, calculates its global efficiency and finally returns the actual available power. For sites of geothermic interest, such as the volcanic island of Ischia in Southern Italy, the results of the application of this new method clearly highlight the most suitable zones for power plants installations

Innovative time-based separation procedures for civil RPAS integration

Purpose: This paper aims to suggest feasible solutions to overcome the problem of unmanned aerial vehicles integration within the existing airspace. Design/methodology/approach: It envisages innovative time-based separation procedures that will enhance the integration in the future air traffic management (ATM) system of next generation of large remotely piloted aircraft system (RPAS). 4D navigation and dynamic mobile area concepts, both proposed in the framework of Single European Sky ATM Research program, are brought together to hypothesize innovative time-based separation procedures aiming at promoting integration of RPAS in the future ATM system. Findings: Benefits of proposed procedures, mainly evaluated in terms of volume reduction of segregated airspace, are quantitatively analyzed on the basis of realistic operational scenarios focusing on monitoring activities in both nominal and emergency conditions. Eventually, the major limits of time-based separation for RPAS are investigated. Practical implications: The implementation of the envisaged procedures will be a key enabler in RPAS integration in future ATM integration. Originality/value: In the current ATM scenario, separation of RPAS from air traffic is ensured by segregating a large amount of airspace areas with fixed dimensions, dramatically limiting the activities of these vehicles

Effect of mannanoligosaccharides supplementation on caecal microbial activity of rabbits

A total of 200 weaned (35 days) hybrid Hyla rabbits were randomly divided among five groups housed in bicellular cages (20 cages per group). Between 35 and 60 days of age, the groups were submitted to the following treatments: group ANT (positive control) fed a basal diet supplemented with antibiotics (colistin sulphate, 144 mg/kg; tylosin, 100 mg/kg; and oxytetracyclin, 1000 mg/kg); groups MOS-0.5, MOS-1.0 and MOS-1.5 fed the basal diet supplemented with 0.5, 1.0 and 1.5 g/kg mannanoligosaccharides (MOS), respectively; another group fed the basal diet without antibiotics or mannanoligosaccarides supplementation (negative control). Along the trial, an episode of epizootyc rabbit enteropathy occurs so that in the control group mortality rate was very high (78%) and survivor rabbits showed severe symptoms of disease (diarrhoea). Thus, the control group was discarded from the trial. At 60 days of age, samples of caecal content were collected from 10 rabbits per group and used as inocula for an in vitro gas production trial. At the end of fermentation (120 h of incubation), organic matter digestibility (OMd), cumulative gas production, fermentation kinetics, pH, volatile fatty acid (VFA) and NH3 productions were measured. Inoculum from MOS-1.0 rabbits showed the significant higher values of OMd (64.21%, P < 0.05), gas production (262.32 ml/g, P < 0.05), acetate (96.99 mmol/g OM, P < 0.05) and butyrate (26.21 mmol/g OM, P < 0.05) than the other groups. Slight differences were recorded among the groups ANT, MOS-0.5 and MOS-1.5. In addition, branched chain acids, in proportion to total VFAs, were significantly higher in MOS-1.0 inoculum (0.04, P < 0.05). MOS are able to affect fermentation activity of caecal micro-organism, but their activities seem not proportional to their level in the diet. Copyright © The Animal Consortium 2010