Strutture organizzative e risorse manageriali nella governance delle imprese internazionalizzate

Nella dimensione globale il concetto sistemico dell'impresa si deve aprire a una molteplicit\ue0 di contesti; la governance si trasferisce al sistema internazionale, mantenendo forti le sue radici nell'ambiente originario, ma allo stesso tempo confrontandosi con nuovi stakeholders, nuove regole, nuove dimensioni statuali. L'attivit\ue0 di governance deve quindi affrontare tutti gli aspetti critici dell'ampliamento e della complessit\ue0 delle attivit\ue0 aziendali, mirando all'efficacia complessiva del sistema attraverso la guida strategica e il coordinamento del vertice, l'autonomia e la valorizzazione delle unit\ue0 periferiche e il loro contributo all'innovazione, l'efficacia del trasferimento delle conoscenze in tutte le direzioni e la gestione delle risorse umane centrali e locali in una prospettiva multiculturale. Si rende quindi fondamentale la gestione e la valorizzazione di quei manager capaci di interpretare il multiculturalismo, rimanendo fedeli all'organizzazione, vivendo pi\uf9 dimensioni dell'organizzazione internazionalizzata, coniugando le esigenze dell'unit\ue0 centrale con quelle delle unit\ue0 periferiche

The Role of Anti-IgE Antibodies in Urticaria

Chronic urticaria, a common mast cell driven disease, has been considered so far an underestimated and difficult to treat disease, very often resulting in high physical, psychological and socio-economic burden. More than 60% of these patients are unresponsive to second generation H1 antihistamines, the first-line symptomatic treatment for urticaria. However, anti-IgE drugs (omalizumab and ligelizumab) showed improved activity in urticaria-treated patients with inadequate symptom control. Omalizumab has been widely proven to be very effective and well-tolerated in patients with antihistamine-refractory chronic spontaneous urticaria and inducible urticaria and is currently licensed for these indication as third-line treatment. Ligelizumab, a next-generation monoclonal anti-IgE antibody with higher affinity to IgE compared to omalizumab and a similar safety profile, has recently demonstrated to be even more effective than omalizumab. This review is focused on the role of anti-IgE antibodies in chronic urticaria

Divergence of Funneliformis mosseae populations over 20 years of laboratory cultivation, as revealed by vegetative incompatibility and molecular analysis

Arbuscular mycorrhizal fungi (AMF) are widespread, important plant symbionts. They absorb and translocate mineral nutrients from the soil to host plants through an extensive extraradical mycelium, consisting of indefinitely large networks of nonseptate, multinucleated hyphae which may be interconnected by hyphal fusions (anastomoses). This work investigated whether different lineages of the same isolate may lose the ability to establish successful anastomoses, becoming vegetatively incompatible, when grown separately. The occurrence of hyphal incompatibility among five lineages of Funneliformis mosseae, originated from the same ancestor isolate and grown in vivo for more than 20 years in different European locations, was assessed by systematic detection of anastomosis frequency and cytological studies. Anastomosis frequencies ranged from 60 to 80% within the same lineage and from 17 to 44% among different lineages. The consistent detection of protoplasm continuity and nuclei in perfect fusions showed active protoplasm flow both within and between lineages. In pairings between different lineages, post-fusion incompatible reactions occurred in 6–48% of hyphal contacts and pre-fusion incompatibility in 2–17%. Molecular fingerprinting profiles showed genetic divergence among lineages, with overall Jaccard similarity indices ranging from 0.85 to 0.95. Here, phenotypic divergence among the five F. mosseae lineages was demonstrated by the reduction of their ability to form anastomosis and the detection of high levels of vegetative incompatibility. Our data suggest that potential genetic divergence may occur in AMF over only 20 years and represent the basis for detailed studies on the relationship between genes regulating anastomosis formation and hyphal compatibility in AMF

Omalizumab in Chronic Spontaneous Urticaria Refractory to Conventional Therapy: An Italian Retrospective Clinical Analysis with Suggestions for Long-Term Maintenance Strategies

Introduction: Omalizumab is indicated for the treatment of patients affected by chronic spontaneous urticaria (CSU) refractory to antihistamines. The aim of this study was to assess the efficacy, safety, and recurrence of symptoms in a real-life experience of omalizumab as an add-on therapy for H1-antihistamine-refractory CSU patients (refractory CSU). Methods: A retrospective review of the clinical records of all refractory CSU treated with omalizumab at our dermatology center from June 2014 to April 2017 was performed. Patients previously treated with second-generation antihistamines at a fourfold increased dose without clinical responses at 4 weeks of treatment were selected. Omalizumab was administered at a single dosage of 300 mg every 4 weeks for 6 months. Disease severity was assessed using the 7-day Urticaria Activity Score (UAS7). Results: Eighteen patients (14 women; mean age 51 years, range 25-74) were enrolled. Mean UAS7 at baseline was 27.3 (range 15-38). Symptoms improved in all patients at 4 weeks (UAS7 = 16.1, range 0-36). Treatment was completed in 17 patients (94.4%), and among these, a complete response (UAS7 = 0) was registered in 10 patients (58.8%). Adverse events included thrombocytopenia in 1 patient (5.6%) at 16 weeks; therapy was suspended after 20 weeks and the complication was resolved, resulting in a freedom from major adverse events of 94.4%. Symptom recurrence occurred in 3 patients (17.6%) at 4, 5, and 7 months from the end of the primary therapy. Retreatment with omalizumab was successful without any adverse effects. Mean follow-up was 9.5 months (range 1-28). Conclusion: Add-on omalizumab therapy for refractory CSU in a real-life setting seems to be effective and safe with a relatively low incidence of symptom recurrence. Further research should investigate personalized omalizumab treatment dosages and administration intervals, and the identification of biomarkers for future treatment algorithms

Pigmented Nodular Basal Cell Carcinomas in Differential Diagnosis with Nodular Melanomas: Confocal Microscopy as a Reliable Tool for In Vivo Histologic Diagnosis

Nodular basal cell carcinoma, especially when pigmented, can be in differential diagnosis with nodular melanomas, clinically and dermoscopically. Reflectance confocal microscopy is a relatively new imaging technique that permits to evaluate in vivo skin tumors with a nearly histological resolution. Here, we present four cases of challenging nodular lesions where confocal microscopy was able to clarify the diagnosis

Effects on Collagen VI mRNA Stability and Microfibrillar Assembly of Three COL6A2 Mutations in Two Families with Ullrich Congenital Muscular Dystrophy

We recently reported a severe deficiency in collagen type VI, resulting from recessive mutations of the COL6A2 gene, in patients with Ullrich congenital muscular dystrophy. Their parents, who are all carriers of one mutant allele, are unaffected, although heterozygous mutations in collagen VI caused Bethlem myopathy. Here we investigated the consequences of three COL6A2 mutations in fibroblasts from patients and their parents in two Ullrich families. All three mutations lead to nonsense-mediated mRNA decay. However, very low levels of undegraded mutant mRNA remained in patient B with compound heterozygous mutations at the distal part of the triple-helical domain, resulting in deposition of abnormal microfibrils that cannot form extensive networks. This observation suggests that the C-terminal globular domain is not essential for triple-helix formation but is critical for microfibrillar assembly. In all parents, the COL6A2 mRNA levels are reduced to 57-73% of the control, but long term collagen VI matrix depositions are comparable with that of the control. The almost complete absence of abnormal protein and near-normal accumulation of microfibrils in the parents may account for their lack of myopathic symptoms

Chronic Spontaneous Urticaria: A Review of Pathological Mechanisms, Diagnosis, Clinical Management, and Treatment

Urticaria is a poorly understood and underestimated clinical condition characterised by the sudden onset of itchy wheals and/or angioedema, which usually resolve within 24 and 72 hours, respectively. It is generally classified as being acute (lasting <6 weeks) or chronic (continuous or intermittent for ≥6 weeks). Chronic urticaria can be further classified as chronic spontaneous urticaria (CSU) and chronic inducible urticaria, appearing in response to specific eliciting factors, such as heat, cold, or sun exposure, or following the application of pressure. Scientific advances have been made in the understanding of pathological mechanisms and treatment, especially associated with CSU. The exact pathological mechanism of how urticaria develops is still not yet fully understood, but the clinical implications on the patients' quality of life are severe and have been associated with mental disorders and metabolic diseases. The diagnosis of urticaria is based on medical history and clinical manifestations. The treatment pathway begins with the administration of second-generation, nonsedating, nonimpairing histamine 1 receptor antihistamines and, in case of nonresponse, with new-generation biological drugs. The current review presents an update of the pathological mechanisms, diagnosis, clinical management, and treatment of CSU. It also focusses on the future implications of new-generation drugs and their effects on the clinical practice