Severe Gram-Negative Intertrigo of the Feet

Introduction: Intertrigo is a common disease of the skin usually caused by fungi and/or bacteria, often involving major or minor skin folds. Here, we report a case of severe, ulcerative intertrigo of all interdigital folds of both feet caused by Pseudomonas aeruginosa in a patient with type II diabetes who acquired the infection during a trip to Senegal. Case Presentation: Lesions involved all toe-web spaces and the back of the toes and the soles. Ulcers with a purulent-necrotic bed, with some of them covered by brownish-black eschars associated with a greenish, odiferous discharge were recorded. The patient was treated with piperacillin/tazobactam IM for 14 days, achieving complete remission of the infection. In this article, we underline the importance of an early diagnosis and appropriate treatment to achieve healing of bacterial intertrigo without complications. Topical therapy with antiseptics (potassium permanganate, gentian violet solution, hydrogen peroxide) or antibiotics (gentamicin, amikacin) is effective only in early stages of the infection. Systemic antibiotics must be considered in all extensive and severe cases. The choice of antibiotic should be based on the culture and antibiogram results. When this is not possible, wide-spectrum antibiotics that act on both gram-positive and gram-negative bacteria (such as third-generation cephalosporin or quinolone) should be prescribed. Conclusion: The length of treatment should not be less than ten days. In addiction, all patients should be trained to avoid predisposing conditions and adopt preventive measures to reduce the risk of infection

Endolimax nana and urticaria.

Endolimax nana is a commensal protozoan of the colon. We report a case of chronic urticaria associated with E. nana in a 34-year-old Italian woman. The patient suffered from abdominal pain, diarrhoea and weight loss. The disease appeared after a trip to Vietnam. Laboratory examinations showed mild blood eosinophilia. Three coproparasitological examinations were positive for cysts of E. nana. The patient was successfully treated with two courses of metronidazole (2 g/day for 10 days each). No antihistamines were used. Three coproparasitological examinations, carried out at the end of the therapy, were negative. Follow up (six months) was negative. E. nana can be responsible for very rare cases of abdominal pain, diarrhoea, polyarthritis and urticaria

Trans-epithelial transport of the betalain pigments indicaxanthin and betanin across Caco-2 cell monolayers and influence of food matrix

Purpose: This study investigated the absorption mechanism of the phytochemicals indicaxanthin and betanin and the influence of their food matrix (cactus pear and red beet) on the intestinal transport. Methods: Trans-epithelial transport of dietary-consistent amounts of indicaxanthin and betanin in Caco-2 cell monolayers seeded on TranswellR inserts was measured in apical to basolateral (AP-BL) and basolateral to apical (BL-AP) direction, under an inwardly directed pH gradient (pH 6.0/7.4, AP/BL) mimicking luminal and serosal sides of human intestinal epithelium. The effect of inhibitors of membrane transporters on the absorption was also evaluated. Contribution of the paracellular route was investigated after EDTA treatment of the cell monolayer. In vitro digestion of betalainic food was performed to provide a post-intestinal fraction containing bioaccessible pigments. Results: Apparent permeability coefficients (P app) in the absorptive direction were (4.4 ± 0.4) × 10-6 and (3.2 ± 0.3) × 10-6 cm s-1 for indicaxanthin and betanin, respectively. Transport of indicaxanthin was non-polarized, linear as a function of time and concentration, and unaffected by inhibitors of membrane transporters. Betanin exhibited significantly different bidirectional P app values and non-linear efflux kinetics. The concentration- dependent betanin efflux was described by a kinetic model including one non-saturable (K d = 0.042 μL cm-2 min-1) and one saturable component identified as the apical multidrug resistance-associated protein 2 (MRP2; K m = 275 μM; J max = 42 pmol min-1 cm-2). Permeation of both betalains increased remarkably after EDTA treatment of the cell monolayer. Neither indicaxanthin nor betanin underwent metabolic transformation. Food matrix did not affect trans-epithelial transfer of indicaxanthin, but reduced the absorption rate of betanin, red beet more than cactus pear. Conclusions: Dietary indicaxanthin and betanin can substantially be absorbed through paracellular junctions of intestinal epithelial cells. Additional trans-membrane permeation can be considered for betanin, whose absorption is limited by a MRP2-mediated efflux and negatively affected by its food matrix. Present findings are consistent with the quite higher bioavailability of indicaxanthin over betanin established in humans. © 2012 Springer-Verlag

Le palme nel paesaggio costiero:quale cambiamento dopo il punteruolo rosso

La presente tesi tratta di come sta cambiando e cambierà il paesaggio costiero tirrenico e, in generale, una volta che il punteruolo rosso, definito da alcuni "insetto paesaggista", avrà devastato e distrutto tutte o pressoché tutte le palme storiche e quelle piantate recentemente (ancora vengono messe incomprensibilmente a dimora soprattutto Phoenix canariensis). Quali specie e/o varietà potranno sostituire queste piante dall'architettura unica e che caratterizzano in filari colonnari molti dei lungomare costieri del nostro Paese? Questa è la domanda che è stata posta agli esperti botanici ed in questa tesi sono documentati i cambiamenti paesaggistici e le soluzioni proposte nei vari contesti, prospettando anche varie soluzioni, in attesa dei prossimi parassiti e malattie! Sono state prese in considerazione alcune tipologie di lungomare delle città di Marsala e Mazara del Vallo (Sicilia), di Salerno (Campania), delle principali cittadine della costa pisana e della Versilia lucchese (Toscana) e di Sanremo (Liguria), ricercando la documentazione storica e fotografica, e rilevando le condizioni climatiche e vegetazionali. Da questa analisi sono state evidenziate le possibili soluzioni paesaggistiche alla problematica del parassita