Speculations on the clinical significance of asymptomatic viral infections

A detailed understanding of asymptomatic chronic viral infections is critical to analyse their pathogenesis, assess the severity and burden of disease and, where required, optimize public health control measures. Recent studies on herpesviruses showed that the hostevirus interactions are modulated by coinfections, emphasizing the relevance of co-infections in determining the clinical expression (from asymptomatic to symptomatic infections) and the severity of herpesvirus-associated diseases (either neoplastic or infectious diseases). To demonstrate causality between viruses (virome) and diseases, Koch's postulates should be adapted adding new knowledge on hostemicrobe relationship and microbial interactions. In the present review we aim to provide an update on asymptomatic chronic infections and criteria for causality and on the virological, immunological and hostevirus interactions in asymptomatic chronic infections in human hosts, focusing on herpetic infections

Entrepreneurship education in Italian universities: trend, situation and opportunities

The aim of this paper is to provide an analysis of the present situation and recent evolution in entrepreneurship courses and curricula in Italian universities. The analysis is based on a census of entrepreneurship courses and curricula run by Italian universities in 2004 and 2010. Entrepreneurship education in Italian universities is in its early development. Up to 2004 only a few universities had courses dedicated to entrepreneurship and the majority of them dealt with the development of the business plan. This situation has only slightly improved in the following years. Courses and curricula are mostly within business schools while very few exist in engineering and science schools. This situation contrasts with the need for entrepreneurship education in the Italian economy. Given the importance of traditional sectors in Italian industry we need to stimulate start-up in high-tech sectors: the development of entrepreneurship courses in engineering and in other science curricula could play an important role in this sense. At the same time we need to favor the growth process of small firms; this requires people who are able to play an entrepreneurial role in established firms.entrepreneurship education, university courses, intrapreneurship, entrepreneurial competences.

Industry 4.0 Accelerating Sustainable Manufacturing in the COVID-19 Era: Assessing the Readiness and Responsiveness of Italian Regions

An unpredictable shock hit the Italian economy in February 2020 when the spread of the COVID-19 virus began in Italy and other countries worldwide. In this context, Industry 4.0 (I4.0) technologies can be a fundamental tool for economic recovery by favouring the shift towards sustainable manufacturing. Therefore, it is necessary to measure the readiness of countries for I4.0 in order to guide policies in defining incentives to promote I4.0 and unlock its potential in the pandemic era. In this context, the paper aims to understand the readiness and responsiveness of the Italian Regions with respect to I4.0 concepts prior to the pandemic and identify best practices that are supporting companies in I4.0 adoption, with a focus on those incentivizing sustainable practices. An assessment framework before the pandemic is provided based on two dimensions: the readiness of firms to invest in I4.0 and favourable structural conditions. The assessment shows a group of alert regions as opposed to a group of unprepared, mostly linked Northern and Southern differences. Assuming that the \u201calert regions\u201d are more likely to effectively manage and overcome the post- COVID-19 crisis, we provide a picture of how the Italian Regions have sought to encourage the adoption of digital technologies to improve resilience after the shock. The analysis shows that supporting measures mainly address Small and Medium-sized Enterprises. Furthermore, the tenders encouraging the adoption of I4.0 suggest that collaboration among stakeholders will become imperati

COVID-19 pneumonia and pulmonary microembolism in a patient with B-thalassemia major

We think that thalassemia is not necessarily a cause of aggravation of the clinical course in COVID-19; however, certain key factors must be considered, such as the anemic condition, the likely pathogenic role of the virus on hemoglobin, and the hypercoagulable state to prevent any complications

A case of central venous catheter-related Candida parapsilosis fungemia evolved to disseminated infection in a neutropenic patient with blast crisis of chronic myeloid leukemia.

Central venous catheter-related infections are of particular importance in onco-hematological patients. Candida parapsilosis is generally reported as a mild pathogen, however it is able to effectively colonize intravascular devices and potentially give rise to sustained fungemias. Here we report a case of invasive, potentially lethal C. parapsilosis disseminated infection in a neutropenic patient affected by chronic myeloid leukemia with blast crisis. We underline the importance of removing the central venous catheter as potential source of infection as soon as possible during the course of candidemia, and not replacing it with other polyurethan intravascular devices, which pose a risk for the maintenance of the fungemia despite the administration of the best antifungal therapy available

Management of Relapsed/Refractory All with Inotuzumab During COVID-19. A Case Report

Management of patients with concomitant acute lymphoblastic leukemia (ALL) and COVID-19 infection is challenging. We describe the clinical history of a 40-year-old male with relapsed B-common ALL who developed Sars-CoV2 prior to treatment initiation with inotuzumab. Since the patient was asymptomatic for COVID-19, the first dose of inotuzumab was administered, followed by remdesivir as prophylaxis. However, a worsening in respiratory findings led to a delay in administering the following doses of inotuzumab. Interestingly, even if the patient did not receive the full inotuzumab cycle, he achieved a complete hematologic remission: furthermore, he spontaneously developed anti-sars-COV2 antibodies. COVID-19 treatment also included convalescent plasma, leading to negativization of the viral load. The patient, after COVID-19 recovery, received a second full cycle of inotuzumab, underwent allogeneic transplantation, and is currently in complete hematologic and molecular remission, in good clinical conditions, five months from allograft

Successful Management of a Chronic Refractory Leg Ulcer in an Adolescent with Sickle Cell Anemia

Sickle cell disease (SCD) is an inherited hemoglobinopathy characterized by a wide range of clinical manifestations. Chronic leg ulcers are a disabling complication with repercussions on the quality of life. We report the case of a 14-year-old girl with a diagnosis of SCD who developed a chronic leg ulcer that was successfully treated with a multi-disciplinary approach, including local and systemic therapies. The role of different treatments, in particular low molecular weight heparin, in the refractory chronic leg ulcer healing process will be discussed. </p

Levofloxacin to prevent bacterial infection in patients with cancer and neutropenia.

BACKGROUND: The prophylactic use of fluoroquinolones in patients with cancer and neutropenia is controversial and is not a recommended intervention. METHODS: We randomly assigned 760 consecutive adult patients with cancer in whom chemotherapy-induced neutropenia (<1000 neutrophils per cubic millimeter) was expected to occur for more than seven days to receive either oral levofloxacin (500 mg daily) or placebo from the start of chemotherapy until the resolution of neutropenia. Patients were stratified according to their underlying disease (acute leukemia vs. solid tumor or lymphoma). RESULTS: An intention-to-treat analysis showed that fever was present for the duration of neutropenia in 65 percent of patients who received levofloxacin prophylaxis, as compared with 85 percent of those receiving placebo (243 of 375 vs. 308 of 363; relative risk, 0.76; absolute difference in risk, -20 percent; 95 percent confidence interval, -26 to -14 percent; P=0.001). The levofloxacin group had a lower rate of microbiologically documented infections (absolute difference in risk, -17 percent; 95 percent confidence interval, -24 to -10 percent; P<0.001), bacteremias (difference in risk, -16 percent; 95 percent confidence interval, -22 to -9 percent; P<0.001), and single-agent gram-negative bacteremias (difference in risk, -7 percent; 95 percent confidence interval, -10 to -2 percent; P<0.01) than did the placebo group. Mortality and tolerability were similar in the two groups. The effects of prophylaxis were also similar between patients with acute leukemia and those with solid tumors or lymphoma. CONCLUSIONS: Prophylactic treatment with levofloxacin is an effective and well-tolerated way of preventing febrile episodes and other relevant infection-related outcomes in patients with cancer and profound and protracted neutropenia. The long-term effect of this intervention on microbial resistance in the community is not known