EXPERIENCES OF UAV SURVEYS APPLIED TO ENVIRONMENTAL RISK MANAGEMENT

In this paper the results of some surveys carried out in an area of Apulian territory affected by serious environmental hazard are presented. Unmanned Aerial Vehicles (UAV) are emerging as a key engineering tool for future environmental survey tasks. UAVs are increasingly seen as an attractive low-cost alternative or supplement to aerial and terrestrial photogrammetry due to their low cost, flexibility, availability and readiness for duty. In addition, UAVs can be operated in hazardous or temporarily inaccessible locations, that makes them very suitable for the assessment and management of environmental risk conditions. In order to verify the reliability of these technologies an UAV survey and A LIDAR survey have been carried outalong about 1 km of coast in the Salento peninsula, near the towns of San Foca, Torre dellOrso and SantAndrea( Lecce, Southern Italy). This area is affected by serious environmental risks due to the presence of dangerous rocky cliffs named falesie. The UAV platform was equipped with a photogrammetric measurement system that allowed us to obtain a mobile mapping of the fractured fronts of dangerous rocky cliffs. UAV-images data have been processed using dedicated software (AgisoftPhotoscan). The point clouds obtained from both the UAV and LIDAR surveys have been processed using Cloud Compare software, with the aim of testing the UAV results with respect to the LIDAR ones. The total error obtained was of centimeter-order that is a very satisfactory result. The environmental information has been arranged in an ArcGIS platform in order to assess the risk levels. The possibility to repeat the survey at time intervals more or less close together depending on the measured levels of risk and to compare the output allows following the trend of the dangerous phenomena. In conclusion, for inaccessible locations of dangerous rocky bodies the UAV survey coupled with GIS methodology proved to be a key engineering tool for the management of environmental risks

Direct-acting antivirals and visceral leishmaniasis: A case report

Background: Visceral leishmaniasis is a vector-borne parasitic disease caused by protozoa belonging to the genus Leishmania. The clinical presentation of visceral leishmaniasis strictly depends on the host immunocompetency, whereas depressive conditions of the immune system impair the capability to resolve the infection and allow reactivation from sites of latency of the parasite. Case presentation: We describe a case of visceral leishmaniasis (VL) that occurred in a patient with chronic hepatitis C treated with direct-acting antiviral drugs (DAA). The hypothesized mechanism is the alteration of protective inflammation mechanisms secondary to DAA therapy. Downregulation of type II and III IFNs, their receptors, which accompany HCV clearance achieved during treatment with sofosbuvir and ribavirin might have a negative impact on a risk for reactivation of a previous Leishmania infection. We know indeed that IFN-\u3b3 is important to enhance killing mechanisms in macrophages, which are the primary target cells of Leishmania. Conclusion: Since VL is endemic in Sicily as well as in other countries of the Mediterranean basin, physicians should be aware of the possible unmasking of cryptic Leishmania infection by DAAs

First case of Mediterranean spotted fever-associated rhabdomyolysis leading to fatal acute renal failure and encephalitis

Mediterranean spotted fever (MSF) is a tick-borne zoonosis caused by Rickettsia conorii. In Italy, about 400 cases are reported every year and nearly half of them occur in Sicily, which is one of the most endemic regions. Although MSF is mostly a self-limited disease characterized by fever, skin rash, and a dark eschar at the site of the tick bite called a 'tache noire', serious complications are described, mainly in adult patients. Nevertheless, severe forms of the disease with major morbidity and a higher mortality risk have been described. We report a fatal case of MSF complicated by rhabdomyolysis, acute renal failure, and encephalitis in an elderly woman

Fever with perinasal and tongue lesions: A diagnostic challenge

The diagnosis may be challenging, and high suspicion index should be maintained in immunosuppressed patients with unusual mucocutaneous lesions, even in non-endemic areas for mucocutaneous leishmaniasis

Leprosy-like cutaneous presentation of Histoplasma capsulatum infection in an African HIV+ patient

Histoplasma capsulatum is an opportunistic dimorphic fungus responsible for most often self-limiting or flu-like infections but potentially lethal in immunocompromised hosts. Histoplasmosis is rare in Europe. We reported a case of disseminated histoplasmosis in an African HIV patient with a leprosy-like primary cutaneous presentation and involvement of lungs, brain, limphnodes and eye. The therapy with liposomial B amphotericin and itraconazole led to a prompt resolution of the symptoms

Congenital cytomegalovirus related intestinal malrotation: a case report

Background: Cytomegalovirus is the most common cause of congenital infection in the developed countries. Gastrointestinal involvement has been extensively described in both adult and paediatric immunocompromised patients but it is infrequent in congenital or perinatal CMV infection. Case presentation: We report on a case of coexistent congenital Cytomegalovirus infection with intestinal malrotation and positive intestinal Cytomegalovirus biopsy. At birth the neonate showed clinical and radiological evidence of intestinal obstruction. Meconium passed only after evacuative nursing procedures; stooling pattern was irregular; gastric residuals were bile-stained. Laparatomy revealed a complete intestinal malrotation and contextually gastrointestinal biopsy samples of the appendix confirmed the diagnosis of CMV gastrointestinal disease. Intravenous ganciclovir was initiated for 2 weeks, followed by oral valgancyclovir for 6 month. Conclusion: CMV-induced proinflammatory process may be responsible of the interruption of the normal development of the gut or could in turn lead to a disruption in the normal development of the gut potentiating the mechanism causing malrotation. We suggest the hypothesis that an inflammatory process induced by CMV congenital infection may be responsible, in the early gestation, of the intestinal end-organ disease, as the intestinal malrotation. CMV infection should always be excluded in full-term infants presenting with colonic stricture or malrotation

Disseminated tuberculosis in a patient treated with a JAK2 selective inhibitor: a case report

Background Primary myelofibrosis is a myeloproliferative disorder characterized by bone marrow fibrosis, abnormal cytokine expression, splenomegaly and anemia. The activation of JAK2 and the increased levels of circulating proinflammatory cytokines seem to play an important role in the pathogenesis of myelofibrosis. Novel therapeutic agents targeting JAKs have been developed for the treatment of myeloproliferative disorders. Ruxolitinib (INCB018424) is the most recent among them. Case presentation To our knowledge, there is no evidence from clinical trials of an increased risk of tuberculosis during treatment with JAK inhibitors. Here we describe the first case of tuberculosis in a patient treated with Ruxolitinib, a male with a 12-year history of chronic idiopathic myelofibrosis admitted to our Institute because of fever, night sweats, weight loss and an enlarging mass in the left inguinal area for two months. Conclusion Treatment with Ruxolitinib may have triggered the reactivation of latent tuberculosis because of an inhibition of Th1 response. Our case highlights the importance of an accurate screening for latent tuberculosis before starting an anti-JAK 2 treatmen

ACALCULOUS CHOLECYSTITIS IN A PATIENT WITH PLASMODIUM FALCIPARUM MALARIA AND CYTOMEGALOVIRUS INFECTION

Acalculous cholecystitis is a syndrome of gallbladder inflammation without gallstones, recognized within the setting of critically ill patients. Acalculous cholecystitis associated with infectious agents is reported in the literature to be rare. Herein we describe a case of acalculous cholecystitis in a patient with malaria caused by Plasmodium falciparum and apparent cytomegalovirus infection, and discuss the possible role of CMV in the pathogenesis of acalculous cholecystitis in patients with malaria

Palatal Rugae as a Discriminating Factor in Determining Sex: A New Method Applicable in Forensic Odontology?

The purpose of this study is a new method that can help to identify the sex through the study of palatal rugae, comparing sagittal sections of the hard palate using Cartesian coordinates and evaluating the assistance given by digital technology and its applicability in this method. In this study, 57 digital impressions were examined and divided in two groups based on sex. Results: 2223 impression sections were studied and 145 coordinates that were present with a frequency greater than 50% in one or both groups were obtained: 52 discriminating traits (DT) in the male group, 29 discriminating traits in the female group, and 64 common traits (CT). The DTs in the female group showed no statistically significant difference from the same coordinates in the male one (p = 0.832). Statistically significant differences were observed in the DTs in the male group compared to the same coordinates in the female group (p = 0.018). No statistically significant differences were observed in the frequency of DTs in both sexes (p = 0.056). Further research in forensic odontology is needed to determine its scientific certainty. It is certain that digital technology may one day be a valuable support for the forensic odontologist but to date the lack of dedicated and certified programs limits its reliability

Efficacy and safety of dolutegravir and doravirine dual therapy in the context of antiretroviral therapy switch: 48 weeks analysis.

Dual therapy in HIV represents an attractive opportunity for HIV infected people in virologic suppression Dual therapy regimens should achieve and maintain viral suppression and immunologic control while minimizing short and long term AEs, improve adherence and convenience and reduce drug drug interactions and costs To date, there are few clinical data to support a dual regimen with dolutegravir and doravirine 1 The individual efficacy of both doravirine and dolutegravir suggests that concomitant administration of these two molecules as part of an NRTI sparing regimen could be a viable option, although to date there are no studies in the HIV infected population The aim of our study is to investigate whether a dual therapy regimen containing dolutegravir and doravirine is effective and saf