Prevenzione delle recidive nel paziente precedentemente trattato con isotretinoina orale

Gli autori presentano la loro esperienza relativa alla prevenzione delle recidive nel paziente acneico precedentemente trattato con isotretinoina orale. In particolare, gli autori dimostrano che, alla fine della terapia con isotretinoina orale, l'utilizzodi un retinoide topico (adapalene allo 0,1% o isotretinoina allo 0,05% o tretinoina allo 0,05%), per un periodo continuativo di 6-8 mesi, limita, in modo statisticamente significativo, la comparsa delle recidive

epiluminescence microscopy in cutaneous larva migrans

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Emergence of Anaplasma Species Related to A. phagocytophilum and A. platys in Senegal

The genus Anaplasma (Anaplasmataceae, Rickettsiales) includes tick-transmitted bacterial species of importance to both veterinary and human medicine. Apart from the traditionally recognized six Anaplasma species (A. phagocytophilum, A. platys, A. bovis, A. ovis, A. centrale, A. marginale), novel strains and candidate species, also of relevance to veterinary and human medicine, are emerging worldwide. Although species related to the zoonotic A. platys and A. phagocytophilum have been reported in several African and European Mediterranean countries, data on the presence of these species in sub-Saharan countries are still lacking. This manuscript reports the investigation of Anaplasma strains related to zoonotic species in ruminants in Senegal by combining different molecular tests and phylogenetic approaches. The results demonstrated a recent introduction of Candidatus (Ca) Anaplasma turritanum, a species related to the pathogenic A. platys, possibly originating by founder effect. Further, novel undetected strains related to Candidatus (Ca) Anaplasma cinensis were detected in cattle. Based on groEL and gltA molecular comparisons, we propose including these latter strains into the Candidatus (Ca) Anaplasma africanum species. Finally, we also report the emergence of Candidatus (Ca) A. boleense in Senegal. Collectively, results confirm that Anaplasma species diversity is greater than expected and should be further investigated, and that Anaplasma routine diagnostic procedures and epidemiological surveillance should take into account specificity issues raised by the presence of these novel strains, suggesting the use of a One Health approach for the management of Anaplasmataceae in sub-Saharan Africa

Instability and network effects in innovative markets

We consider a network of interacting agents and we model the process of choice on the adoption of a given innovative product by means of statistical-mechanics tools. The modelization allows us to focus on the effects of direct interactions among agents in establishing the success or failure of the product itself. Mimicking real systems, the whole population is divided into two sub-communities called, respectively, Innovators and Followers, where the former are assumed to display more influence power. We study in detail and via numerical simulations on a random graph two different scenarios: no-feedback interaction, where innovators are cohesive and not sensitively affected by the remaining population, and feedback interaction, where the influence of followers on innovators is non negligible. The outcomes are markedly different: in the former case, which corresponds to the creation of a niche in the market, Innovators are able to drive and polarize the whole market. In the latter case the behavior of the market cannot be definitely predicted and become unstable. In both cases we highlight the emergence of collective phenomena and we show how the final outcome, in terms of the number of buyers, is affected by the concentration of innovators and by the interaction strengths among agents.Comment: 20 pages, 6 figures. 7th workshop on "Dynamic Models in Economics and Finance" - MDEF2012 (COST Action IS1104), Urbino (2012

Clindamycin phospate-zinc acetate versus clindamycin phosphate-zinc acetate + adapalene in the treatment of mild to moderate acne. Results of a multicentre, randomized, retrospective, sponsor-free study

Introduction: The aim of the present study was to evaluate the efficacy and the response in patients with mild to moderate acne of a clindamycin phosphate-zinc acetate topical therapy in comparison with clindamycin phosphate-zinc acetate plus adapalene. Methods: Patients with mild to moderate acne were randomized into two groups and treated, respectively, with a gel containing 1 % clindamycin phosphate-0.5% zinc acetate (2 applications/day for 12 weeks) or with the same gel (1 application/day for 12 weeks) plus a gel containing 0.1% adapalene (1 application/day for 12 weeks). No other topical or systemic drugs were allowed, except for a detergent and a sunscreen. Acne severity and treatment efficacy were evaluated by means of the Global Acne Grading System (GAGS). Results: At the end of the study, 63 patients were considered evaluable (29 patients in the group treated with clindamycin-zinc and 34 in the group treated with clindamycin-zinc and adapalene). Significant clinical improvement (maggiore/uguale 50% from baseline) was observed in 12/29 patients (41.4%) in the group treated with clindamycin-zinc and in 22/34 patients (64.7%) in the group treated with clindamycin-zinc and adapalene (p< 0.05). Irritant contact dermatitis was observed in 12 patients (3 in the group treated with clindamycin-zinc and 9 in the group treated with clindamycin-zinc and adapalene); in the latter group, two patients stopped the treatment. Conclusions: On the basis of the results of this study, which is the first one on the activity and tolerability of the association clindamycin-zinc, the latter association is less effective than the association clindamycin-zinc and adapalene

Prevention of relapses in patients previously treated with oral isotretinoin for severe acne. Results of a multicentre, randomized, retrospective, sponsor-free study

Introduction: After a systemic treatment with oral isotretinoin, acne therapy must be continued with topical products in order to avoid possible relapses. The aim of this study was to assess whether a topical retinoid is an effective choice in the prevention of relapses. Methods: Patients who were successfully treated with oral isotretinoin for severe acne, at the end of the therapy were randomized into two groups: the first one was treated with a topical retinoid (0.05% tretinoin or 0.05% isotretinoin or 0.1 % adapalene, 1 application/day for 6-8 months); the second group was not treated (only detergents and moisturizers were allowed). Follow up was >6 months. Results: At the end of the study, 2/37 patients (5.4%) treated with topical retinoids developed a relapse; in the group of patients who were not treated, 7/31 patients (22.6%) developed a relapse (p< 0.05). Conclusions: On the basis of the results of this study, topical retinoids are helpful in the prevention of relapses of acne in patients previously treated with oral isotretinoin

Os retratos de Maria Isabel e Maria Francisca de Bragança, de Nicolas-Antoine Taunay

Nicolas-Antoine Taunay, French landscape painter, produced also several portraits during his stay at the Rio de Janeiro Court. In this city, in 1816, he paints the queen Carlota Joaquina and all her daughters. In this group, two portraits have a very special way: the paintings still today catalogued as Maria Francisca and Maria Teresa, but probably being Maria Isabel and Maria Francisca de Assis - princesses that, in this year, left Brazil to marry the Spanish King Fernando VII, and his brother Carlos Maria Isidro de Bourbon. In this article, beyond to describe these portraits (and analyse the identities of the portrayed princesses), I analyse their functions in the Court society and the mains artists of this gender in Europe. I will discuss, as well, the hypothesis about the Taunay choices. In this sense, I will analyse the possible circulation of the typologies of portrait between Italy, Portugal, Spain and France, understanding these productions by Taunay and the functions occupied by these portraits in the political relations between Brazil and Europe.Nicolas-Antoine Taunay, pintor de paisagens francês, também realizou alguns retratos durante sua estadia na corte do Rio de Janeiro. Nessa cidade, em 1816, ele pinta a rainha Carlota Joaquina e todas as suas filhas. Nesse conjunto, dois retratos sobressaem-se de modo especial: os hoje ainda inventariados como de Maria Francisca e de Maria Teresa, mas que provavelmente são o de Maria Isabel e o de Maria Francisca de Assis - princesas que, nesse ano, deixavam o Brasil para casar-se, respectivamente, com Fernando VII, o rei espanhol, e com seu irmão Carlos Isidro de Bourbon. Neste artigo, além de descrevermos os retratos (e analisarmos a questão da identidade das princesas retratadas), abordamos suas funções na sociedade das cortes e os principais artistas do gênero na Europa. Discutimos, também, as hipóteses que permeiam as escolhas de Taunay para sua execução. Nesse sentido, tratamos da possível circulação de tipologias entre Itália, Portugal, Espanha e França, buscando entender a forma como Taunay os realizou e as funções que doravante tais retratos ocupariam nas relações entre o Brasil e a Europa.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Economic consequences of investing in anti-HCV antiviral treatment from the Italian NHS perspective : a real-world-based analysis of PITER data

OBJECTIVE: We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy. METHODS: A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered. RESULTS: The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively. CONCLUSIONS: This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV