A case report of a rare intramuscular granular cell tumor

Background: Granular cell tumors (GCTs) were firstly described by Weber in 1854 and 70 years later by Abrikossoff and classified as benign tumors. Originally considered muscle tumors, they have been identified as neural lesions, due to their close association with nerve and to their immunohystochemical characteristics. GCTs are uncommon tumors and they may arise in any part of the body; they have been mainly observed in tongue, chest wall and upper extremities; less frequent sites are larynx, gastrointestinal tract, breast, pituitary stalk and the female anogenital region. Here we report a case of GCT showing an uncommon localization such as the upper third of the right rectus muscle of the abdominal wall. Case presentation: A 45 year-old woman of Caucasian origin presented to the surgeon with a 6-month history of light pain in the upper third of the abdominal wall. Radiological exams (Ultrasonography, Computed Tomography and Contrast magnetic resonance imaging) showed a localized in the right rectus abdominis muscle. After excision, histological and immunohystochemical analysis, with the support of electron microscopy, allowed making diagnosis of granular cell tumor. Discussion: After fist description by Abrikosoff in 1926 of GCT like mesenchymal tumor of unknown origin, in recent years immunohystochemical techniques definitely demonstrated the histogenetic derivation of GCT from Schwann cells. Granular cell tumors are rare, small, slow-growing, solitary and painless subcutaneous nodules which behave in a benign fashion, but can have a tendency to recur; in rare cases they can metastasize, when they became malignant; there are some clinical and histological criteria to suspect the malignance of this tumor. Conclusion: It is important that clinicians, radiologists and pathologists are aware of the clinical presentation and histopathology of GCT for appropriate management, counselling and follow-up. In our case we had a complete radiological, morphological and immunohystochemical characterization of the lesion and a definitive diagnosis of benignity confirmed by electron microscopy

The role of subsidence in a weakly unstable marine boundary layer: a case study

The diurnal evolution of a cloud free, marine boundary layer is studied by means of experimental measurements and numerical simulations. Experimental data belong to an investigation of the mixing height over inner Danish waters. The mixed-layer height measured over the sea is generally nearly constant, and does not exhibit the diurnal cycle characteristic of boundary layers over land. A case study, during summer, showing an anomalous development of the mixed layer under unstable and nearly neutral atmospheric conditions, is selected in the campaign. Subsidence is identified as the main physical mechanism causing the sudden decrease in the mixing layer height. This is quantified by comparing radiosounding profiles with data from numerical simulations of a mesoscale model, and a large-eddy simulation model. Subsidence not only affects the mixing layer height, but also the turbulent fluctuations within it. By analyzing wind and scalar spectra, the role of subsidence is further investigated and a more complete interpretation of the experimental results emerges

Off-Label Use of Dalbavancin for Sequential Treatment of Spondylodiscitis by Methicillin-Resistant Staphylococcus aureus: A Retrospective Single-Centre Experience

Background: Our aim was to describe the clinical outcome and safety of the sequential treatment with off-label dalbavancin in patients with spondylodiscitis that is caused by methicillin-resistant Staphylococcus aureus (MRSA). Methods: We retrospectively included all patients >18 years of age with spondylodiscitis that is caused by MRSA that was treated with dalbavancin from January 2018-January 2021, recording the instances of clinical cure/failure, adverse events, and the need to be re-hospitalized after the initiation of dalbavancin. In 2/15 patients, we performed therapeutic drug monitoring (TDM) for dalbavancin. Results: We included 15 patients, 53.3% of them were females, with a median age of 67.9 years (57.4-78.5); 100% patients reported back pain, while a fever was present only in 2/15 cases. The spondylodiscitis was localized in 86.6% cases at the lumbar level. A median of a 2-week in-hospital intravenous vancomycin was followed by dalbavancin with a median duration of 12 weeks (12-16). All patients reported a clinical cure, except for a woman who is still on a suppressive treatment. No patient needed to be re-hospitalized, access to emergency department, or experienced adverse events. The TDM for dalbavancin showed that more than 90% of the determinations were above the pharmacodynamic target against staphylococci. Conclusions: The results from our unique, even if it was small, cohort demonstrated that dalbavancin can be a safe/effective option as a sequential treatment in patients with serious infections requiring prolonged antibiotic therapy, such as spondylodiscitis

Neuromotor development and visual acuity in premature infants submitted to early visuo-motor stimulation

To investigate the effects of early visual stimulation on the development of tonus and posture control and of grating visual acuity of preterm infants, eight infants received visual stimulation that induced head motion during the first 6 months of life in weekly sessions. Their performance was compared with that of unstimulated preterm infants of same age (n = 6). Both groups were evaluated in the developmental scale of Gesell and had their grating visual acuity measured by swept visually evoked potentials (sweep-VEP). Visuomotor performance and adoption and maintenance of postures were significantly better for the stimulated group (p < .05) compared to the unstimulated group. There was no statistical difference between the two groups for the development of visual acuity. Visuo-motor and postural development improved with the early visuo-motor stimulation program. The lack of influence of this program in the development of visual acuity may be attributed to differences in the pathways involved in the processing of visual acuity of patterns and in the responses elicited by visuo-motor stimulation.Universidade de São PauloUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Social isolation impairs active avoidance performance and decreases neurogenesis in the dorsomedial telencephalon of rainbow trout

Alterations in the social environment, such as isolating an individual that would normally live in a social group, can generate physiological responses that compromise an individual's capacity to learn. To investigate this, we tested whether social isolation impairs learning skills in the rainbow trout. We show that rainbow trout can achieve an active avoidance (AA) learning program with inter-individual variability. Moreover, c-Fos expression in dorsomedial telencephalon (Dm) correlates with the AA performance, indicating that this structure is involved in this cognitive task. Given that Dm participates in AA learning and this region is under plastic remodelling by addition of new-born neurons, we tested whether social isolation impinges on adult neurogenesis and, consequently, on the Dm cognitive outcome. Trout were reared for four weeks in control or isolated conditions. We found that social isolation diminished the percentage of adult-born neurons that are being incorporated into Dm network. Interestingly, the same isolation treatment also induced a severe deficit in the AA performance. Our results demonstrate a structure-to-function relationship between the Dm and the learning ability in an AA task, indicate that social isolation reduces the incorporation of adult-born neurons into Dm, and show that social isolation impairs the Dm-related cognitive function.Fil: Ausas, Maria Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; Argentina. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; ArgentinaFil: Mazzitelli Fuentes, Laura Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; Argentina. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; ArgentinaFil: Román, Fernanda Ruth. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; Argentina. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; ArgentinaFil: Crichigno, Sonia Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto Andino Patagónico de Tecnologías Biológicas y Geoambientales. Universidad Nacional del Comahue. Instituto Andino Patagónico de Tecnologías Biológicas y Geoambientales; ArgentinaFil: de Vincenti, Ana Paula. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Mongiat, Lucas Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; Argentina. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; Argentin

Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals

The study was presented at the 21st Conference of the National Society of Infectious Diseases and Tropical Medicine ‘Congresso Nazionale Società Italiana Malattie Infettive e Tropicali’, 20–23 November 2022, Rome, Italy (Poster PP259).OBJECTIVES: Thanks to its long half-life, dalbavancin qualifies as an optimal drug for saving costs. We aimed to assess the cost and effectiveness of dalbavancin versus the standard of care (SoC). PATIENTS AND METHODS: Thanks to its long half-life, dalbavancin qualifies as an optimal drug for saving costs. We aimed to assess the cost and effectiveness of dalbavancin versus the standard of care (SoC). RESULTS: One hundred and twenty-six of 228 (55.3%) patients received SoC, while 102/228 (44.7%) received dalbavancin. Twenty-seven of the 102 (26.5%) patients received dalbavancin as first-line treatment, 46 (45.1%) as second-line, and 29 (28.4%) as third- or higher-line treatment. Most patients received dalbavancin as monotherapy (62/102; 60.8%). Compared with SoC, dalbavancin was associated with a significant reduction of LOS (5 ± 7.47 days for dalbavancin, 9.2 ± 5.59 days for SoC; P < 0.00001) and with lower mean direct medical costs (3470 ± 2768€ for dalbavancin; 3493 ± 1901€ for SoC; P = 0.9401). LOS was also reduced for first-line dalbavancin, in comparison with second-, third- or higher-line groups, and for dalbavancin monotherapy versus combination therapy. Mean direct medical costs were significantly lower in first-line dalbavancin compared with higher lines, but no cost difference was observed between monotherapy and combination therapy. CONCLUSIONS: Monotherapy with first-line dalbavancin was confirmed as a promising strategy for ABSSSIs in real-life settings, thanks to its property in reducing LOS and saving direct medical costs.https://www.ncbi.nlm.nih.gov/pmc/journals/4039School of Health Systems and Public Health (SHSPH