Tinea incognito Caused by Microsporum gypseum in a Patient with Advanced HIV Infection: A Case Report

The prevalence and the clinical relevance of dermatophytoses in HIV-infected patients are poorly documented, particularly for those caused by tinea incognito. Here, we report a case of widespread facial tinea incognito occurring in an Italian patient with advanced HIV infection, showing both skin and brain lesions. Second-line treatment with liposomal amphotericin B and cotrimoxazole, administered after a microbiological characterization of the skin scrapings, led to complete clearance of all lesions

Penerapan Metode Peer Teaching Untuk Meningkatkan Hasil Belajar Kognitif Siswa Pada Mata Pelajaran Pendidikan Agama Islam Materi Puasa Wajib dan Puasa Sunah : Penelitian Tindakan Kelas di Kelas VIII-G (Delapan) SMPN 31 Bandung

Masalah yang sangat menonjol yang di hadapi dalam pelajaran PAI yang bermula dari fenomena yang muncul di lapangan yaitu hasil belajar siswa yang masih rendah. Hal ini terlihat dari hasil belajar siswa dan hasil ulangan siswa masih banyak yang berada di bawah KKM 76 hampir 70%. Salah satu faktor yang mempengaruhi hasil belajar siswa adalah metode yang sesuai. Oleh karena itu, diperlukan metode yang baru dan interaktif, agar pemahaman siswa pada materi pelajaran menjadi optimal sehingga hasil belajar mereka pun dapat meningkat sesuai dengan yang diharapkan. Penelitian ini bertujuan untuk mengetahui (1) Hasil belajar kognitif siswa sebelum diterapkan metode Peer Teaching pada mata pelajaran PAI siswa kelas VIII-G; (2) Proses pembelajaran siswa kelas VIII-G dengan menggunakan metode Peer Teaching pada mata pelajaran PAI siswa kelas VIII-G; (3) Hasil belajar kognitif siswa kelas VIII-G pada mata pelajaran PAI setelah diterapkan metode Peer Teaching. Metode peer teaching dinilai dapat dimanfaatkan sebaik-baiknya dalam pelajaran Pendidikan Agama Islam. Kelebihan dari metode ini adalah (1) Meningkatkan motivasi belajar siswa; (2) Meningkatkan kualitas dan proses pembelajaran; (3) Meningkatkan hasil belajar. Penelitian ini merupakan Penelitian Tindakan Kelas yang dilakukan dalam 3 siklus. Setiap siklus terdiri dari 1 pertemuan dengan tahapan-tahapan (1) Perencanaan; (2) Tindakan; (3) Observasi; (4) Refleksi. Tahapan-tahapan ini dilakukan untuk meningkatkat hasil belajar kognitif siswa pada mata pelajaran PAI materi Puasa Wajib dan Puasa Sunah. Setelah melakukan penelitian, disimpulkan bahwa (1) hasil belajar kognitif siswa sebelum diterapkannya metode Peer Teaching masih banyak siswa yang mendapatkan nilai di bawah rata-rata KKM, (2) Proses pembelajaran dengan menggunakan metode Peer Teaching setiap siklusnya mengalami peningkatan yang sangat signifikan, dengan kegiatan intinya adalah siswa di bantu oleh temannya sendiri ketika belajar di kelas dan (3) Hasil belajar kognitif siswa setelah diterapkan metode Peer Teaching yaitu setiap siklusnya mengalami peningkatan, terlihat pada siklus I dengan rata-rata 72.37 termasuk kategori baik, ketuntasan belajar klasikal sebesar 36.84% dengan jumlah 14 siswa tuntas belajar, siklus II nilai rata-rata meningkat menjadi 80 termasuk kategori sangat baik, sehingga nilai rata-rata dari siklus I ke siklus II meningkat sebesar 7.63%, ketuntasan belajar klasikal sebesar 86.84% dengan jumlah 33 siswa tuntas belajar sehingga ketuntasan belajar klasikal dari siklus I dan II meningkat sebesar 50%, dan siklus III terjadi peningkatan nilai rata-rata yang signifikan menjadi 96.05 termasuk kategori sangat baik, sehingga nilai rata-rata dari siklus II ke siklus III meningkat sebesar 16.05% semua siswa masuk pada kategori tuntas sehingga persentasi kelulusan 100%. Dengan demikian, pembelajaran Pendidikan Agama Islam dengan menggunakan metode peer teaching dapat meningkatkan hasil belajar kognitif siswa

Acupuncture for the treatment of severe acute pain in Herpes Zoster: results of a nested, open-label, randomized trial in the VZV Pain Study

<p>Abstract</p> <p>Background</p> <p>Data on the potential efficacy of acupuncture (AC) in controlling intense or very intense pain in patients with Herpes Zoster (HZ) has not been so far adequately assessed in comparison with standard pharmacological treatment (ST) by a controlled trial design.</p> <p>Methods</p> <p>Within the VZV Pescara study, pain was assessed in HZ patients on a Visual Analogue Scale (VAS) and by the McGill Pain Questionnaire (MPQ) both at the beginning and at the end of treatment. Response rates, mean changes in pain intensity, differences in total pain burden with an area-under-the-curve (AUC) method over a 1-year follow-up and differences in the incidence of Post-Herpetic Neuralgia (PHN) were evaluated.</p> <p>Results</p> <p>One hundred and two patients were randomized to receive either AC (n = 52) or ST (n = 50) for 4 weeks. Groups were comparable regarding age, sex, pain intensity at presentation and missed antiviral prescription. Both interventions were largely effective. No significant differences were observed in response rates (81.6% vs 89.2%, p = 0.8), mean reduction of VAS (4.1 +/- 2.3 vs 4.9 +/- 1.9, p = 0.12) and MPQ scores (1.3 +/- 0.9 vs 1.3 +/- 0.9, p = 0.9), incidence of PHN after 3 months (48.4% vs 46.8%, p = 0.5), and mean AUC during follow-up (199 +/- 136 vs 173 +/- 141, p = 0.4). No serious treatment-related adverse event was observed in both groups.</p> <p>Conclusions</p> <p>This controlled and randomized trial provides the first evidence of a potential role of AC for the treatment of acute herpetic pain.</p> <p>Trial registration</p> <p>ChiCTR-TRC-10001146.</p

Genetic determinants in a critical domain of ns5a correlate with hepatocellular carcinoma in cirrhotic patients infected with hcv genotype 1b

HCV is an important cause of hepatocellular carcinoma (HCC). HCV NS5A domain‐1 interacts with cellular proteins inducing pro‐oncogenic pathways. Thus, we explore genetic variations in NS5A domain‐1 and their association with HCC, by analyzing 188 NS5A sequences from HCV genotype‐1b infected DAA‐naïve cirrhotic patients: 34 with HCC and 154 without HCC. Specific NS5A mutations significantly correlate with HCC: S3T (8.8% vs. 1.3%, p = 0.01), T122M (8.8% vs. 0.0%, p &lt; 0.001), M133I (20.6% vs. 3.9%, p &lt; 0.001), and Q181E (11.8% vs. 0.6%, p &lt; 0.001). By multivariable analysis, the presence of &gt;1 of them independently correlates with HCC (OR (95%CI): 21.8 (5.7–82.3); p &lt; 0.001). Focusing on HCC‐group, the presence of these mutations correlates with higher viremia (median (IQR): 5.7 (5.4–6.2) log IU/mL vs. 5.3 (4.4–5.6) log IU/mL, p = 0.02) and lower ALT (35 (30–71) vs. 83 (48–108) U/L, p = 0.004), suggesting a role in enhancing viral fitness without affecting necroinflammation. Notably, these mutations reside in NS5A regions known to interact with cellular proteins crucial for cell‐cycle regulation (p53, p85‐PIK3, and β‐ catenin), and introduce additional phosphorylation sites, a phenomenon known to ameliorate NS5A interaction with cellular proteins. Overall, these results provide a focus for further investigations on molecular bases of HCV‐mediated oncogenesis. The role of these NS5A domain‐1 mutations in triggering pro‐oncogenic stimuli that can persist also despite achievement of sustained virological response deserves further investigation

ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats

An update to the 2007 American College of Veterinary Internal Medicine (ACVIM) consensus statement on the identification, evaluation, and management of systemic hypertension in dogs and cats was presented at the 2017 ACVIM Forum in National Harbor, MD. The updated consensus statement is presented here. The consensus statement aims to provide guidance on appropriate diagnosis and treatment of hypertension in dogs and cats

Study of energy savings and environmental and economic impact of resilient cooling technologies in existing buildings

Ecosystems and the built environment are greatly impacted by climate change brought on by human activity. Due to its alterations, local extreme events occur more frequently and more severely, increasing their fatalities and economic costs. The Mediterranean area is particularly affected by heatwaves, which are extremely critical for health and productivity of people inside the dwellings as well as for energy consumptions related to cooling demand. These events also increase the chance of power outages, which disable the operation of electrically powered cooling systems like air conditioning, raising the likelihood of indoor overheating. For these reasons, buildings play a crucial part in mitigating the effects of changing climate, in the optic of being resilient to new average conditions and extreme events. Resilience describes the ability of a building to withstand or recover from disruptions, taking advantage from its design and/or adopting appropriate strategies for returning to original conditions in a fast and efficient manner. This study investigated the resilience of different cooling technologies in the most common construction in Catalan building stock during present and future climatic conditions, heatwaves and power outages, evaluating also their impact on energy consumptions, environment and costs. The techniques implemented in the model include green roof, blinds, advanced windows, natural ventilation, air conditioning and their combinations. Typical years and heatwaves for the city of Barcelona have been created for three time periods, Present, Mid Future and Long Future. They have been modelled using dynamical downscaled Regional Climate Models, climate projections based on IPCC scenarios. Power outages have been simulated in some of these scenarios, following a new methodology that predicted their occurrence during the days and the hours with higher exposition to this risk. Resilience was assessed using indicators that take into account the linear correlation between the grade of overheating inside a dwelling and the severity of outdoor conditions. Thermal comfort and survivability have been also investigated, evaluating sensations of building’s occupants related to indoor air temperature and relative humidity. In some cases, hours of exceedance and evolution of operative temperature inside the most critical apartments have been visualized. A potential scenario for future electric generation was simulated, based on the plan of the Spanish government for reducing emission by 2030, in order to evaluate the impact of passive measures in the reduction of primary energy use, carbon emissions and costs associated with the use of air conditioning. The original building presented acceptable levels of resilience, while thermal comfort conditions resulted poor, especially during heatwaves. The application of the different cooling technologies significantly helped in the improvement of resilience and survivability inside the dwelling. However, their performances reduced in the future scenarios, especially in the ones presenting severe outdoor conditions. Air conditioning resulted the best solution for avoiding overheating inside the apartments, especially in case of heatwaves. On the other hand, natural ventilation achieved good results in the improvement of resilience and comfort, as well as in the reduction of cooling and total energy demand of the building. Combinations of several passive measures resulted necessary for maintaining suitable conditions in case of power outages and reducing environmental impact and costs related to the use of air conditioning, which confirmed the importance of the building envelope condition