Botulinum toxin B ultrasound-guided injections for sialorrhea in amyotrophic lateral sclerosis and Parkinson's disease.

BACKGROUND: Either botulinum toxins (BoNTs) A and B have been used for improving drooling in different neurological conditions. METHODS: Consecutive patients affected by Amyotrophic Lateral Sclerosis (ALS) or Parkinson's Disease (PD) accompanied by severe drooling were randomized to receive botulinum neurotoxin type A (BoNT-A) or B (BoNT-B) injections into the salivary glands. Following the first treatment, when sialorrhea returned to baseline (at least three months after the first injection), subjects were re-treated with the other serotype. Ultrasound-guided injections into parotid and submandibular glands were bilaterally performed: total doses were 250 U BoNT-A (Dysport) and 2500 U BoNT-B (Neurobloc). Objective (cotton roll weight) and subjective (ad hoc clinical scales) evaluations were performed at baseline, after 1 and 4 weeks, and every 4 weeks until drooling returned to baseline. RESULTS: Twenty-seven patients (15 ALS and 12 PD) were enrolled, fourteen completed the study. BoNT-A and BoNT-B treatments gave both subjective and objective improvements in all patients. The latency was significantly shorter after BoNT-B treatments (3.2 \ub1 3.7 days) compared to BoNT-A (6.6 \ub1 4.1 days; P = 0.002). The mean benefit duration was similar at 75 and 90 days for BoNT-A and BoNT-B, respectively (P = NS). The only toxin-related side effect was a change to saliva thickness. CONCLUSIONS: Either 250 U Dysport or 2500 U Neurobloc have similar effectiveness and safety in controlling sialorrhea. BoNT-B has a shorter latency and comparable duration. Cost analysis, considering the doses used in this study protocol favored BoNT-B treatment

Fecal calprotectin in management of Clostridium difficile infection: a longitudinal study

Background: Clostridium difficile infection (CDI) is characterized by a relevant intestinal neutrophil infiltrate. So far, role of fecal calprotectin in CDI, has been investigated only in few studies, mainly focused on diagnosis of the disease. Aim: By a longitudinal design, we assess fecal calprotectin concentrations (FCCs) in subjects with CDI, evaluating the correlation between fecal marker and response to therapy. Methods: Clinical (diarrhea scoring) and laboratory (FCCs and leucocytes count) evaluation was performed in 56 subjects with CDI at time of diagnosis (T0) and after a week from starting of therapy (T1). Clinical response to therapy at T1was related with both T0and T1FCC values. FCCs were also related to all-cause 30-day mortality, recurrence and death, both of them within 90 days. Results: FCCs at T1were significantly increased in subjects with persistence of diarrhea in respect to the other ones (285.5\ue2\u80\u89\uc2\ub1\ue2\u80\u89270 \uc2\ub5g/g vs 150.7\ue2\u80\u89\uc2\ub1\ue2\u80\u89147 \uc2\ub5g/g, respectively; p\ue2\u80\u8

Reclamo al CICR- commento all'art.9 TUB

Il reclamo al CICR resta apparentemente immutato come reclamo nazionale avverso i provvedimenti di vigilanza, mentre gli assetti dei poteri di vigilanza bancaria sono da tempo profondamente riconfigurati e incentrati sulla BCE. Nel nuovo sistema di vigilanza è previsto un diverso procediento di reclamo. Si affronta, quindi, principalmente il problema della convivenza dei due rimedi