GENETIC AND THERAPEUTIC NOVELTIES IN ATOPIC DERMATITIS

Atopic dermatitis (atopic eczema) is a common affection in children, characterized by exacerbations and remissions. The forms may be mild, moderate or severe, the problem of treatment is in moderate and severe forms. Fully understanding this condition can revolutionize the therapy used so far. New generations of target drugs are being studied, some of which have promising results. By reviewing these results, new research opportunities are opened up

Total Economic Value of Natural Capital – A Case Study of Piatra Craiului National Park

In the last two decades different methodologies for assessing the economic implications of protected areas have been developed within the framework of “Total Economic Value”, taking into account not only goods and services that have a price and a market but also those not priced or marketed. The present paper, by using a number of recognized methodologies applied by environmental economists around the world, estimates the economic value of ecosystem services of Piatra Craiului National Park, in one of the first attempts to frame ecosystem services valuation in Romania. The approach and results include a benefit distribution analysis, for both the economic sectors and the groups of beneficiaries. Even if the data are not comprehensive and depend on several assumptions, the paper provides very important practical and policy-relevant information on the economic value of Piatra Craiului National Park, in an attempt to stimulate increasing of the budgetary allocation and economic policy priority for protected areas in Romania

Total Economic Value of Natural Capital - A Case Study of Piatra Craiului National Park

In the last two decades different methodologies for assessing the economic implications of protected areas have been developed within the framework of “Total Economic Value”, taking into account not only goods and services that have a price and a market but also those not priced or marketed. The present paper, by using a number of recognized methodologies applied by environmental economists around the world, estimates the economic value of ecosystem services of Piatra Craiului National Park, in one of the first attempts to frame ecosystem services valuation in Romania. The approach and results include a benefit distribution analysis, for both the economic sectors and the groups of beneficiaries. Even if the data are not comprehensive and depend on several assumptions, the paper provides very important practical and policy-relevant information on the economic value of Piatra Craiului National Park, in an attempt to stimulate increasing of the budgetary allocation and economic policy priority for protected areas in Romania

PREDICTION OF HIV PREVALENCE UNTIL 2022 IN ROMANIA AND THE EUROPEAN UNION

In the last decade, AIDS diagnosis has decreased, most likely through easier access to treatment and faster management of HIV infections. Due to the decrease in the number of AIDS patients, the reduction of deaths and the idea of eradication of AIDS can be considered. For all of this, we need to look at the HIV infection that causes AIDS. HIV infection at European level has been declining in recent years, yet there are still countries that continue to grow. Late diagnosis, pre-exposure prophylaxis and the lack of proper education in prevention are still a problem in some European Union countries

PROBLEMS OF DOCTOR-PATIENT COMMUNICATION IN MEDICAL PRACTICE. WAYS TO APPROACH THE PATIENT IN COMPLICATED CASES

Currently, the physician-patient relationship is a bidirectional one, the center of which is communication. Communication is no longer regarded as an option but as a necessity in the day-to-day practice of physicians. The way we use communication can make a big difference on the physician-patient relationship, on the understanding of the disease, the treatment, and on the subsequent conduct of the patient. The approach to this subject comes in the absence of formal courses for doctors in communication, a necessary and beneficial thing both for the doctor and for the patient

Sex differences in the effectiveness of first-line tumour necrosis factor inhibitors in axial spondyloarthritis: results from the EuroSpA Research Collaboration Network

Objective Evidence indicates reduced treatment effectiveness of TNFi in women with axial spondyloarthritis (axSpA) compared with men. We aimed to investigate sex differences in treatment response and retention rates over 24 months of follow-up in axSpA patients initiating their first TNFi.Methods Data from axSpA patients initiating a TNFi in 1 of 15 registries within EuroSpA collaboration were pooled. We investigated the association of sex with treatment response using logistic regression. The primary outcome was clinically important improvement (CII) at 6 months according to Ankylosing Spondylitis Disease Activity Score with C-reactive protein (CRP) (≥1.1 decrease). We adjusted for age, country and TNFi start year. A secondary outcome was retention rates over 24 months of follow-up assessed by Kaplan-Meier estimator.Results In total, 6451 axSpA patients with data on CII were assessed for treatment response; 2538 (39%) were women and 3913 (61%) were men. Women presented at baseline with lower CRP levels but had higher scores on patient-reported outcome measures. At 6 months, 53% of the women and 66% of the men had CII. Women had a lower relative risk of CII compared with men (0.81; 95% CI 0.77 to 0.84). This sex difference was similar in adjusted analysis (0.85; 95% CI 0.82 to 0.88). Retention rates were evaluated in 27 702 patients. The TNFi 6/12/24 months retention rates were significantly lower among women (79%/66%/53%) than men (88%/79%/69%).Conclusion Treatment response and retention rates are lower among women with axSpA initiating their first TNFi. Sex differences in treatment effectiveness were present regardless of the outcome measure used for treatment response, and differences in retention rates transpired early and increased as time progressed

A germline variant in the TP53 polyadenylation signal confers cancer susceptibility

Contains fulltext : 97569.pdf (publisher's version ) (Closed access)To identify new risk variants for cutaneous basal cell carcinoma, we performed a genome-wide association study of 16 million SNPs identified through whole-genome sequencing of 457 Icelanders. We imputed genotypes for 41,675 Illumina SNP chip-typed Icelanders and their relatives. In the discovery phase, the strongest signal came from rs78378222[C] (odds ratio (OR) = 2.36, P = 5.2 x 10(-17)), which has a frequency of 0.0192 in the Icelandic population. We then confirmed this association in non-Icelandic samples (OR = 1.75, P = 0.0060; overall OR = 2.16, P = 2.2 x 10(-20)). rs78378222 is in the 3' untranslated region of TP53 and changes the AATAAA polyadenylation signal to AATACA, resulting in impaired 3'-end processing of TP53 mRNA. Investigation of other tumor types identified associations of this SNP with prostate cancer (OR = 1.44, P = 2.4 x 10(-6)), glioma (OR = 2.35, P = 1.0 x 10(-5)) and colorectal adenoma (OR = 1.39, P = 1.6 x 10(-4)). However, we observed no effect for breast cancer, a common Li-Fraumeni syndrome tumor (OR = 1.06, P = 0.57, 95% confidence interval 0.88-1.27)

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology