Majocchi’s Granuloma by Trichophytum rubrum in a kidney transplant patient - A case report

Introduction: Trichophytum rubrum is a filamentous fungus, with worldwide distribution, that usually causes superficial infections of skin and nails, namely tinea pedis, tinea corporis, tinea cruris and onychomycosis. Rarely, severe dermatophytosis can occur, presenting as deep dermatophytosis, Majocchi’s Granuloma or extensive dermatophytosis. Objectives and Methods: Case report of Majocchi’s Granuloma in a kidney transplant patient. Results: A case of a 55-year-old woman who underwent a kidney transplant 7 months before, under immunosuppressive therapy with tacrolimus and mycophenolate mofetil. She attended a Dermatology consultation to clarify skin lesions that appeared 6 months earlier. The skin exam revealed hard and painful plaque lesions on both legs, with an ulcer on the left leg lesion, violaceous papular lesions on the dorsum of the left foot and toes and a hard consistency nodule on the left leg. Some of the toe nails presented dystrophy or onycholysis. The patient denied any previous trauma or contact with plants or soil. Biopsies of lesions of the left leg and foot dorsum where sent for histology and mycological culture and toe nails for mycological culture. The histological examinations showed, in the reticular dermis and reaching the hypodermis, suppurative granulomas with multinucleated giant cells and areas of necrosis. PAS (Periodic Acid- Schiff) and GMS (Grocott’s Methenamine Silver) staining revealed multiple spores and septate hypha within the granulomas but not in the stratum corneum. No remnants of hair follicles where found. Culture of skin biopsies were positive for Tricophytum rubrum but nails´ culture was negative. Identification was further confirmed by sequencing of ITS region of ribosomal DNA (GenBank accession number MK967277). Oral Itraconazole 100mg bid and topic Sertoconazole where initiated. The patient was observed one month after and reported general malaise, tiredness, exertional dyspnea, whitish stools and increased abdominal volume. The physician chose to discontinue itraconazole and initiate oral terbinafine 250mg id. After two months on oral terbinafine, there was regression of the legs´ and left foot lesions with ulcer healing and disappearance of the left leg nodule. Conclusion: Diagnosis of deeper dermatophytosis is difficult, in part because there is no specific clinical presentation and, in many cases, it is even polymorphic. However, especially in patients with immunodeficiency, this hypothesis should be weighed. Confirmation is achieved by finding hyphae compatible with dermatophytes in the dermis and a positive culture for a dermatophyte. Treatment should include systemic antifungal agents, to which topical medication may be associated. Multiple therapeutic regimens have been proposed, but randomized trials or large case series are lacking. Antifungal therapy should be continued until the lesions are completely resolved. Surgical treatment has been reported as an option for highly localized lesions.info:eu-repo/semantics/publishedVersio

Production of doubly charged vector bilepton pairs at γγ\gamma \gamma colliders

The production of pairs of doubly charged vector bileptons is studied at future $\gamma \gamma$ colliders. The unpolarized cross--section for the $\gamma \gamma \to Y^{--}Y^{++}$ subprocess is analytically calculated and convoluted to predict the number of events in the complete $e^+e^-\to \gamma \gamma \to Y^{--}Y^{++}$ process. The gauge or non--gauge character of the vector bilepton $Y^{\pm \pm}$ is discussed. It is found that as a consequence of its spectacular signature, as it decays dominantly into two identical charged leptons, and also due to its charge contents, which significantly enhance the cross--section, the detection of this class of particles with mass in the sub--TeV region can be at the reach of these colliders. The model--independent nature of our results is stressed.Comment: 9 pages, 7 figures, submitted to physical review

Millimeter observations of Planetary Nebulae: a contribution to the Planck pre-launch catalogue

We present new millimetre 43 GHz observations of a sample of radio-bright Planetary Nebulae. Such observations were carried out to have a good determination of the high-frequency radio spectra of the sample in order to evaluate, together with far-IR measurements (IRAS), the fluxes emitted by the selected source in the millimetre and sub-millimetre band. This spectral range, even very important to constraint the physics of circumstellar environment, is still far to be completely exploited. To estimate the millimetre and sub-millimetre fluxes, we extrapolated and summed together the ionized gas (free-free radio emission) and dust (thermal emission) contributions at this frequency range. By comparison of the derived flux densities to the foreseen sensitivity we investigate the possible detection of such source for all the channels of the forthcoming ESA's PLANCK mission. We conclude that almost 80% of our sample will be detected by PLANCK, with the higher detection rate in the higher frequency channels, where there is a good combination of brighter intrinsic flux from the sources and reduced extended Galactic foregrounds contamination despite a worst instrumental sensitivity. From the new 43 GHz, combined with single-dish 5 GHz observations from the literature, we derive radio spectral indexes, which are consistent with optically thin free-free nebula. This result indicates that the high frequency radio spectrum of our sample sources is dominated by thermal free-free and other emission, if present, are negligible.Comment: Submitted to A&A, 6 pages, 3 figure

Intrahepatic persistent fetal right umbilical vein: a retrospective study

Introduction: To appraise the incidence and value of intrahepatic persistent right umbilical vein (PRUV). Methods: This was a single-center study. Records of all women with a prenatal diagnosis of intrahepatic PRUV were reviewed. The inclusion criteria were women with gestational age greater than 13 weeks of gestation. Exclusion criteria were fetuses with situs abnormalities, due to the hepatic venous ambiguity, and extrahepatic PRUV. The primary outcome was the incidence of intrahepatic PRUV in our cohort. The secondary outcomes were associated malformations. Results: 219/57,079 cases (0.38%) of intrahepatic PRUV were recorded. The mean gestational age at diagnosis was 21.8 ± 2.9 weeks of gestations. PRUV was isolated in the 76.7%, while in 23.3% was associated with other major or minor abnormalities. The most common associated abnormalities were cardiovascular abnormalities (8.7%), followed by genitourinary abnormalities (6.4%), skeletal abnormalities (4.6%), and central nervous system abnormalities (4.1%). Within the cardiovascular abnormalities, the most common one was ventricular septal defect (six cases). Conclusion: In most cases PRUV is an isolated finding. Associated minor or major malformations are presented in the 23.3% of the cases, so this finding should prompt detailed prenatal assessment of the fetus, with particular regard to cardiovascular system

Entropic Entanglement Criteria for Continuous Variables

We derive several entanglement criteria for bipartite continuous variable quantum systems based on the Shannon entropy. These criteria are more sensitive than those involving only second-order moments, and are equivalent to well-known variance product tests in the case of Gaussian states. Furthermore, they involve only a pair of quadrature measurements, and will thus should prove extremely useful the experimental identification of entanglement.Comment: 4 pages, 2 figure

Hyperbolic equations in wavelet bases

In this paper we discuss the problem of representing hyperbolic differential operators using orthonormal wavelet bases. A numerical algorithm is shortly outlined and a numerical experiment in the linear magnetohydrodynamics, as a test problem, is eventually outlined.В статті обговорено проблему представлення гіперболічних диференційних операторів з використанням ортонормованих вейвлет-базисів. Коротко описано розрахунковий алгоритм, а також чисельний експеримент з області лінійної магнітогідродинаміки, який виступає в ролі тестової задачі.В статье обсуждена проблема представления гиперболических дифференциальных операторов с использованием ортонормированных вейвлет-базисов. Коротко описан расчетный алгоритм, а также численный эксперимент из области линейной магнитогидродинамики, выступающий в роли тестовой задачи

The PKU & ME study: A qualitative exploration, through co-creative sessions, of attitudes and experience of the disease among adults with phenylketonuria in Italy

Background: Phenylketonuria (PKU) is a hereditary metabolic disease that can be diagnosed and successfully treated from birth with a lifelong phenylalanine-restricted dietary regimen. However, optimal adherence to diet remains an issue and often progressively decreases after adolescence. The study aimed to explore the experience of adults living with PKU in order to gain insights related to their adherence to diet and engagement in managing their condition. Methods: The study adopted a qualitative methodology in sessions that combined specifically designed co- creation exercises with focus group discussion. Adults with early-treated classic PKU were enrolled for 2 different sessions - one for adherent and one for non-adherent patients. The verbatim notes of both sessions and focus group were analyzed using content analysis. Results: Twelve adherent and nine non-adherent adults with PKU participated. Besides the behavioral dictates of following a strict diet, adherent adults reported a positive mental approach and organizational rigor; they seemed aware of the consequences of high-phenylalanine levels, reporting that it can affect mood and conse- quently social interactions which they value highly. In the non-adherent group, the individuals seemed to not fully accept their disease: they were aware of the consequences of non-adherence in children but not in adults, they felt the management of PKU was an individual burden and they experienced a feeling of \u2018diversity\u2019 in the social context (related to eating) that caused emotional distress. PKU seemed a very influential element of the identity both for adherent and non-adherent adults, but with different consequences for the two groups. Finally, all participants reported the desire to be assisted in a healthcare setting dedicated to adults. Conclusions: The findings expand the understanding of the psychological experience of adult patients with PKU in relation to their disease and its dietary requirements, highlighting specific factors that might drive tailored educational or psychological intervention to improve adherence and engagement in the care process