Search

The Bengal tiger (Panthera tigris tigris) is a species belonging to the Felidae family. In Argentina, tigers are currently only found in captivity. The longevity of individual animals in human‐controlled environments depends on proper management and practices that prioritize animal welfare. Regular veterinary care is essential to maintain optimal health conditions. Professionals must have a comprehensive understanding of the anatomy and physiology of tigers to effectively perform medical procedures and administer treatments. The study described in the text focuses on the trajectory and distribution of nerves in the pelvic limb of a Bengal tiger specimen, providing detailed dissection findings. The results revealed that the lumbosacral plexus is formed from the ventral rami of the LIV, LV, LVI, LVII, SI, SII and SIII nerves. Among the observations to highlight is the great development of the nerves N. cutaneus femoris lateralis and N. cutaneus femoris caudalis some differences were observed in the distribution of the N. femoralis and N. obturatorius; the N. ischiadicus, together with its division into the fibularis communis and tibialis nerves, showed the same configuration observed in other cats. Finally, it was observed that the nerves N. gluteus cranialis and N. gluteus caudalis also originated from the truncus lumbosacralis. The similarities and differences with studies carried out on other cats are relevant and provide anatomical data for medical procedures in the Bengal tiger. [ABSTRACT FROM AUTHOR]

Problem: A strong association between periodontitis and higher susceptibility to pregnancy complications like preeclampsia has been reported although the mechanisms remain elusive. Trophoblast cells modulate the recruitment and functional shaping of maternal leukocytes at early stages to sustain an antiinflammatory microenvironment and fetal growth. Neutrophil activation with reactive oxygen species (ROS) release is associated with preeclampsia. Our aim was to study the effect of the gingival crevicular fluid (GCF) from pregnant women on trophoblast cell function and trophoblast‐neutrophil interaction. Method of study: Pregnant women at 16–20 weeks of gestation (n = 27) and non‐pregnant women (n = 8) as the control group were studied for gingivoperiodontal clinical score evaluation and GCF collection. Total bacteria and common periodontal pathogens were analyzed in GCF samples. The effect of each GCF sample was tested on first trimester trophoblast‐derived cells to assess cell migration, cytokine expression and glucose uptake. Also, the effect of GCF on human peripheral neutrophil chemoattraction by trophoblast cells and ROS formation was assessed. Results: Gingival crevicular fluid from pregnant women reduced trophoblast cell migration, increased proinflammatory marker expression and glucose uptake. A significant correlation between gingivoperiodontal score and trophoblast dysfunction was observed. Upon conditioning of trophoblast cells with GCF, only the GCF from pregnant women stimulated neutrophil chemoattraction. Similarly, GCF from pregnant but not from non‐pregnant controls stimulated ROS formation in neutrophils. Conclusions: Gingival crevicular fluid from pregnant women is deleterious for first trimester trophoblast cell function. These effects could lead to placental homeostasis disruption underlying a pathogenic mechanism of pregnancy complications associated to periodontal disease. [ABSTRACT FROM AUTHOR]

Therefore, hospitals needed to combine prevention of in-hospital SARS-CoV-2 spread and maintenance of standard of care for non-SARS-CoV-2 patients. Managing a SARS-CoV-2-free Hospital Unit of Internal Medicine to avoid in-hospital clusters Keywords: cluster; hospital; SARS-CoV-2 EN cluster hospital SARS-CoV-2 1 4 4 03/11/22 20220401 NES 220401 Besides its terrible claim in terms of human lives, SARS-CoV-2 pandemic hit hard also on the hospital management with most healthcare facilities being overwhelmed by hundreds of patients with SARS-CoV-2-related symptoms. [Extracted from the article]

QI-QIV: quartiles of length of stay in ED gl Longer stay at emergency department predicts overall in-hospital mortality during the first w... Patients discharge after hospitalization in internal medicine wards formally not SARS-CoV-2-dedicated took place mostly at home (60.88%), while frailer patients were transferred to nursing homes (5.8%) (Table S5). Keywords: emergency department; ferritin; internal medicine; lactate dehydrogenase; mortality; SARS-CoV-2 EN emergency department ferritin internal medicine lactate dehydrogenase mortality SARS-CoV-2 1 7 7 12/29/21 20220101 NES 220101 INTRODUCTION SARS-CoV-2 represents a "Pandora's box" highlighting critical issues for in-hospital management of infectious patients. Longer stay at emergency department predicts late SARS-CoV-2 positivity Out of 478 hospitalizations in internal medicine wards not SARS-CoV-2-dedicated, a total of 40 patients presented late positivity (8.3%). Although we considered a 14 days window as suggested by the WHO, the median incubation time for SARS-CoV-2 infection was six days long, in line with reported in literature.11,12 Being the median ED hospitalization length shorter (three days), both out-hospital infection and in-hospital spreading of SARS-CoV-2 infection should be considered. [Extracted from the article]

Background: Arthroplasties in elderly patients are surgeries performed to ensure their quality of life. Perioperative care with specific nutrients can improve nutrition status and metabolic response to orthopedic surgeries, such as total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods: Retrospective study with elderly patients divided into 2 groups: control and immunonutrition. The immunonutrition group was instructed to start oral intake of the nutrition supplement 5 days before and to resume it 5 days after arthroplasty (200 mL, 3 times per day). The following were analyzed as primary and secondary outcomes: length of stay (LOS), infectious and noninfectious complications, need for intensive care unit (ICU), transfusion requirement, and C‐reactive protein. Results: A total of 3015 elderly patients met the inclusion criteria: control group (n = 1398) and immunonutrition group (n = 1617). Overall, 81.2% were women and mean age was 72.6 ± 6.9 years. Immunonutrition group had a shorter LOS in hours (32.0 ± 19.4 vs 56.0 ± 26.4; P <.001) and lower rates of infectious complications (2.2% vs 4.6%; P <.001). Noninfectious complications and need for ICU also had lower rates in the immunonutrition group. In the logistic regression analysis, immunonutrition reduced the chance of infectious complications by 55% (odds ratio [OR], 0.45; 95% CI, 0.30–0.68; P <.001) even after adjusting for variables (OR, 0.45; 95% CI, 0.28–0.71; P <.001). Conclusion: Perioperative immunonutrition in elderly patients undergoing THA or TKA may shorten postoperative LOS and reduce infectious and noninfectious complications and transfusion requirement. [ABSTRACT FROM AUTHOR]

Finally, teledermatology was not investigated in our survey due to ongoing clinical validation and medico-legal restrictions..9,10 In conclusion, healthcare quality and patient safety appear to have been generally guaranteed in melanoma management during the COVID-19 pandemic in Italy. Healthcare and safety of patients with melanoma during the COVID-19 Pandemic in Italy Effects of the COVID-19 pandemic on care of melanoma patients in Berlin, Germany: the Mela-COVID survey. [Extracted from the article]

The Solanum glaucophyllum Desf. has been used to treat and prevent diseases in human and veterinary medicine. On the other hand, plant poisoning causes several bone diseases, among them osteoporosis, which is characterized by osteoblastic hypoplasia. Because the osteoblast is a cell derived from the differentiation of mesenchymal stem cells (MSCs) from bone marrow, the hypothesis is that the plant reduces the osteogenic differentiation of MSCs. The objective of this study was to evaluate the effects of S. glaucophyllum Desf. extract on MSCs cultured in osteogenic differentiation medium. We determined by liquid chromatography that 1 ml of plant extract contained 3.8 μl of 1,25(OH)2D3 (calcitriol). Four groups of MSCs cultivated in osteogenic medium were evaluated as follows: (a) treated with 100 μl of extract/L containing 0.4 μg/L of calcitriol; (b) treated with 1 ml of extract/L containing 4 μg/L of calcitriol; (c) treated with 5 ml of extract/L containing 20 μg/L of calcitriol; and (d) a control group without extract. We performed alkaline phosphatase activity assay, analysis of MTT conversion to formazan, and evaluated the percentage of cells, and number and diameter of mineralization nodules. The expression of gene transcripts for osteopontin, bone sialoprotein and BMP‐2 was analysed by RT‐qPCR. After 21 days, there was a significant reduction in MTT conversion to formazan in treated groups, of the cellularity in the group with 5 ml of extract/L, and in the number and size of mineralization nodules in the groups treated with 1 and 5 ml of extract/L. The 5 ml extract/L concentration also reduced transcript expression of osteopontin. It is concluded that S. glaucophyllum Desf. at concentrations of 1 and 5 ml extract/L reduced mineralized matrix synthesis in MSCs cultivated in osteogenic differentiation medium, which suggests that this is one of the mechanisms by which osteoporosis occurs in intoxicated animals. [ABSTRACT FROM AUTHOR]

Lichen planus (LP) is a chronic inflammatory and immune‐mediated disease that affects the skin, hair, nails and mucous membranes. Although there is a broad clinical spectrum of lichen planus manifestations, the skin and oral cavity remain the major sites of involvement. A group of European dermatologists with a long‐standing interest and expertise in lichen planus has sought to define therapeutic guidelines for the management of patients with LP. The clinical features, diagnosis and possible medications that clinicians can use, in order to control the disease, will be reviewed in this manuscript. The revised final version of the lichen planus guideline was passed on to the European Dermatology Forum (EDF) for a final consensus with the European Academy of Dermatology and Venereology (EADV). [ABSTRACT FROM AUTHOR]

Psoriasis has been controversially associated with risk of non‐Hodgkin lymphoma (NHL) and mycosis fungoides (MF). Also patients who developed MF after systemic treatment for psoriasis have been reported, and some authors suggested that the association between MF and psoriasis is not infrequent. We performed an extensive literature review in order to examine the risk of developing MF in psoriatic patients with a systematic search of the English‐language databases. An increased risk for lymphoma overall in psoriatic patients has been found only by three out of seven studies. The risk of developing MF in psoriatic patients has been investigated by different studies in different populations and with different methodologies presenting bias and limitations, and it seems reasonable that misclassification between psoriasis and MF may explain the association reported. In contrast to the large number of psoriatic patients treated with biologicals, only 27 case reports of MF after biological therapy for psoriasis have been reported, and in 10 cases, the initial psoriasis diagnoses were then revised as MF. A true association between MF and psoriasis is possible, but the real incidence and prevalence are still unknown. The reported higher risk of developing MF in psoriatic patients should be reconsidered in the light of the bias of misclassification and the low magnitude reported in previous studies. There is not enough evidence to support a causal relation among biological therapies and MF in psoriatic patients. [ABSTRACT FROM AUTHOR]

Cutaneous papillomas (CP) are one of the most common skin neoplasms in dogs. Different murine models have shown that persistent activation of the phosphatidylinositol 3‐kinase/Akt/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway has a central role in the development and progression of CP. The purpose of this study were to evaluate the immunohistochemical expression pattern of two key molecules involved in the PI3K/Akt/mTOR signalling pathway, pAktSer473, and pS6Ser235/236, on 36 canine specimens of CP using a tissue microarray. The results show that the PI3K/Akt/mTOR signalling pathway is persistently activated in CP of dogs, pointing to this pathway as a potential therapeutic target. [ABSTRACT FROM AUTHOR]

Total body computed tomography (CT) scan and positron emission tomography (PET) revealed only a paratracheal lesion consistent with BPNCD. Dear Editor, A 63-year old man presented in May 2019; for 3 weeks, he complained of a slowly enlarging asymptomatic lesion on his left chest. [Extracted from the article]

Slender walls with discontinuities at their bases, such as flag walls or walls with door openings or access, are common in Chilean practice because of the architectural requirements at facades, first floors, and underground levels. However, there is limited information about the behavior of such elements, and no designs or guidelines in the current codes consider the effects of discontinuities at the base. In this work, two analytical models are presented that estimate the yield displacement, yield curvature, and ultimate curvature of walls with openings, such as flag walls (setback), based on the dimensions of the opening and the longitudinal boundary steel ratio calibrated from a parametric analysis of a nonlinear finite element model. The results indicate that these discontinuities can have a major impact on the elastic displacement, reducing it because of the presence of a more rigid section above the opening, and also on the inelastic component, by increasing the curvature (and the strain) at the wall base because the opening tends to confine the plastic hinge within that area. [ABSTRACT FROM AUTHOR]

The Quequén Grande River (QGR) is a large catchment (10 000 km2) in the Pampa Plain in Argentina. From November 2004 to April 2013, a hydrochemical and stable isotopes monitoring program was conducted, which included three sampling stations of monthly composite precipitation, weekly samples in two sites along the river and several groundwater samples. A standard data interpretation was initially performed applying standard statistics, Piper diagrams and δ18O versus δ2H diagrams. The time evolution of the values of δ18O in precipitation and streamwater were also determined. The integration of hydrogeochemistry and stable isotopes data indicates the existence of three main components of streamflow: (i) baseflow characterized by electrical conductivity (EC) from 1200 to 1800 µs/cm and an isotope composition quite constant around δ18O −5.3‰ and δ2H −33.8‰. Water age for groundwater contribution is typically around 30 to 40 years using chlorofluorocarbons; (ii) direct runoff composed of channel interception and overland flow, which is of low EC in the order of 50 to 100 µs/cm, and a highly variable isotopic composition; and (iii) translatory flow (pre-event water that is stored within the subsoil) with an intermediate EC and isotopic composition close to that of the weighted average composition of precipitation. The hydrochemical and stable isotopic data allow the differentiation between baseflow and direct runoff. In addition to this, chlorofluorocarbon dating is a useful tool in assessing the dominance of baseflow in a stream. The data lead to a conceptual model in which an intermediate flow system, with mean residence time (MRT) of around 35 years, discharges into the drainage network. A regional flow system (MRT > 50 years) discharges to the ocean. It is concluded that in this large plain catchment streamflow separation, only two components can be applied in: (i) short storm precipitation events having a high sampling frequency and (ii) during long dry periods when pre-event soil water is not released. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Previous earthquakes, such as the 2010 Maule earthquake in Chile, have demonstrated the need to establish suitable predictors of compressive or tensile strains in concrete or steel in reinforced concrete shear walls, which can provide limit states or confinement requirements. Slender walls are commonly controlled by flexural deformations that can be divided into elastic and inelastic components. This study provides calibrated expressions for the elastic and inelastic components of flexural deformations using a fiber model for slender walls. These expressions are obtained for rectangular and T-shaped walls. The elastic component is dependent on the axial load and the boundary steel reinforcement ratio. The impact of wall coupling is investigated, which requires a correction for the elastic component. The investigation of the inelastic component is based on a plastic hinge model, in which the length of the plastic hinge is a function of the lateral inelastic drift of the wall among other parameters. The traditional linear inelastic curvature distribution over the wall height is also modified for cases with steel reinforcement with a long yield plateau or low strain hardening, which results in a larger curvature at the wall base. The distribution is validated with experimental data from the literature. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The diagnosis was collision tumour of a dermatofibroma with sebaceous hyperplasia and a Clark naevus. Collision tumours are defined by the fortuitous coexistence of two or more adjacent but histopathologically distinct primary tumours;[[3]] the combination of a basal cell carcinoma with a seborrhoeic keratosis is the most common type.[[4]] Collision tumours represent a diagnostic challenge; dermoscopy becomes necessary to identify the different structures of each neoplasm.[[3]] Patient 1 presented a multicomponent pattern that together with the history of growth induced to excise it. Dermoscopic findings in a collision tumor composed of a dermatofibroma and a melanocytic nevus mimicking melanoma. [Extracted from the article]

We describe a computational approach for the automatic recognition and classification of atomic species in scanning tunnelling microscopy images. The approach is based on a pipeline of image processing methods in which the classification step is performed by means of a Fuzzy Clustering algorithm. As a representative example, we use the computational tool to characterize the nanoscale phase separation in thin films of the Fe-chalcogenide superconductor FeSexTe1-x, starting from synthetic data sets and experimental topographies. We quantify the stoichiometry fluctuations on length scales from tens to a few nanometres. [ABSTRACT FROM AUTHOR]

Data from our institution (local referral center for skin cancers) comparing the period of time from January 1, 2019, to December 31, 2019, versus January 1, 2020, to December 31, 2020, showed an overall reduction of outpatients visits (20,384 vs. 11,374; -44%) and follow-up visits of melanoma patients with digital dermoscopy (956 vs. 619; -35%); therefore, a reduction of surgical procedures for skin cancers (1,120 vs. 956; -14%) and last melanoma diagnoses (138 vs. 87; -37%). Regarding melanoma thickness, the reduction was observed in both melanomas with <0.8 mm Breslow thickness (97 vs. 64; -33%) and T1b or with >0.8 mm Breslow index (41 vs. 23; -43%) and consequently of sentinel lymph node biopsies (SLNB; 36 vs. 18; -50%). Dear Editor, We read with interest the article of Valenti et al.1 about the impact on skin cancer progression and prognosis due to the COVID-19 pandemic. [Extracted from the article]

Aims Aggressive epidermotropic cutaneous CD8+ lymphoma is currently afforded provisional status in the WHO classification of lymphomas. An EORTC Workshop was convened to describe in detail the features of this putative neoplasm and evaluate its nosological status with respect to other cutaneous CD8+ lymphomas. Methods and results Sixty-one CD8+ cases were analysed at the workshop; clinical details, often with photographs, histological sections, immunohistochemical results, treatment and patient outcome were discussed and recorded. Eighteen cases had distinct features and conformed to the diagnosis of aggressive epidermotropic cutaneous CD8+ lymphoma. The patients typically present with widespread plaques and tumours, often ulcerated and haemorrhagic, and histologically have striking pagetoid epidermotrophism. A CD8+/ CD45 RA+/ CD45 RO−/ CD2−/ CD5−/ CD56− phenotype, with one or more cytotoxic markers, was found in seven of 18 patients, with a very similar phenotype in the remainder. The tumours seldom involve lymph nodes, but mucosal and central nervous system involvement are not uncommon. The prognosis is poor, with a median survival of 12 months. Examples of CD8+ mycosis fungoides, lymphomatoid papulosis and Woringer-Kolopp disease presented the typical features well documented in the CD4+ forms of those diseases. Conclusions Aggressive epidermotropic cutaneous CD8+ lymphoma is a distinct lymphoma that warrants inclusion as a distinct entity in future revisions of lymphoma classifications. [ABSTRACT FROM AUTHOR]

Background Incidence rates of malignant melanoma have been increasing worldwide and metastatic melanoma is still a significant problem despite widespread prevention programmes. Objectives We made a systemic review of all metastasized melanoma patients treated at the Department of Dermatology, Medical University of Graz in the years 2000-2010 and looked at the kind of melanoma type, e.g. if it has been slowly growing superficial spreading melanoma ( SSM) or fast growing nodular melanoma ( NM). Methods Histological slides and clinical images of patients treated at our department between 2000 and 2010, who received chemotherapy because of proven metastatic disease were analysed with regard to growth type of their primary tumours. Results A total of 88 patients met the inclusion criteria. Mean age of all patients was 57 years (median 59 years, SD ± 15 years). Of these 88 patients 51 patients (58%) (28 male patients and 23 female patients) had SSM; mean age 58 years (median 58 years, SD ± 14 years) and 37 patients (42%) (18 male patients and 19 female patients) had NM; mean age 56 years (median 61 years, SD ± 17 years). Mean Breslow thickness in the SSM group was 2.26 mm (median: 1.6 mm, SD ± 2.11 mm). In the NM group, mean Breslow thickness was 4.59 mm (median: 3.50 mm, SD ± 4.07 mm). When separated by gender, 46 melanomas were seen in the male group (28 SSM and 18 NM) and 42 melanomas in the female group (23 SSM and 19 NM). Conclusions Our results showed that more than half of the patients with metastatic disease had SSMs and not, as suspected, NMs. As SSMs are growing over a longer period to become invasive and potentially metastatic, there might be a chance to focus primary and secondary prevention programmes not only on fast growing tumours but also on slowly changes of tumours. [ABSTRACT FROM AUTHOR]

Stings in the head region are considered to be a risk factor for severe systemic reactions to hymenoptera stings. We supposed that stings in skin areas, which are well supplied with blood, lead to more severe reactions and tested our hypothesis in 847 patients with confirmed hymenoptera venom allergy. However, symptom severity was independent from sting site: only 16.3% of patients with severe reactions were stung on the head ( P = 0.017). But we confirmed age > 40 years ( P < 0.001) as well as elevated basal tryptase levels ( P = 0.001) as risk factors. Taking antihypertensive drugs seemed to have an influence: 41.7% of patients taking antihypertensive drugs experienced a severe reaction compared to 29.5% of patients, not taking such drugs ( P = 0.019). However, considering patients' age in regression analysis, taking antihypertensive drugs had no effect on symptom severity ( P = 0.342). Importantly, in most patients with severe reactions, cutaneous signs were absent ( P < 0.001). [ABSTRACT FROM AUTHOR]

Background Recent studies investigated the value of teledermatology (TD) as a valid tool for a dermatologist-directed triage systems. Objective To investigate the feasibility of a store-and-forward TD triage system in a large number of patients. Methods Previously trained general practitioners selected suspicious skin tumours in the setting of a general preventive medicine screening programme and transmitted their dermoscopic images via virtual private network for decisionmaking. Within 48 h, two teleconsultants highly experienced in dermoscopy first assessed image quality, then made a diagnosis and answered if lesions were tofollow-up, to excise or to be re-evaluated at face-to-face (FTF). Results A total of 955 lesions were telediagnosed [743 (78%) benign melanocytic, six (0.6%) malignant melanocytic, 186 (19%) benign non-melanocytic and 20 (2%) malignant non-melanocytic]. Excision was recommended for 111 (12%) lesions, 10 lesions (1%) were referred to FTF examination. Follow-up was recommended for 707 (74%) lesions. The vast majority of the lesions (82%) were screened as benign and an intervention was requested in only 18% of cases. Eighty-two patients (12% of the total) were lost at follow-up. The diagnostic accuracy was of 94% with sensitivity of 100% and specificity of 95.8%. Conclusions We confirm that TD is suitable to triage skin cancers. [ABSTRACT FROM AUTHOR]

Background Ultraviolet radiation (UVR) induces various alterations of the skin and plays a decisive part regarding the development of melanoma and non-melanoma skin cancer. For a closer examination of these phenomena in vivo reflectance confocal microscopy (RCM) is one of the most eligible options as it represents a diagnostic tool that allows a non-invasive examination of the skin, showing microanatomical structures and individual cells. Objectives The aim of this study was using RCM to observe alterations of the skin induced by UVR and to describe the development of these changes. In addition, the findings were compared with histological examinations of the same area. Methods A small area in the gluteal region of 10 healthy subjects was exposed to a threefold individual minimal erythema dose of solar-simulated UVR. The following development of the sunburn reaction was evaluated with RCM 1, 24, 72 h and 1 week after UVR exposure. Furthermore, RCM images of unexposed skin were obtained, serving as a reference. To contrast histological examination with RCM, punch biopsies were performed at each point in time. The obtained data were interpreted regarding histological and RCM-based criteria on sunburn reaction. Results All important UVR-induced alterations of the skin could be shown in RCM beginning with an inflammatory reaction (inflammatory cells, vasodilatation, oedema), containing the formation of microvesicles, followed by the appearance of apoptotic keratinocytes (sunburn cells), activated melanocytes and at last, loss of the epidermal structure. There was an excellent correlation between RCM and histological features. Conclusions Reflectance confocal microscopy is a highly valuable tool for non-invasive monitoring of UVR-induced changes of the skin over time. Furthermore, RCM provides a more detailed visualization of inflammatory cell formation and epidermal blood flow than histological examination can. [ABSTRACT FROM AUTHOR]

Background Various dermoscopic features are usually associated with benign melanocytic lesions. Our objective was to determine frequency and extension of benign dermoscopic features ( BDF) in melanoma. Methods Retrospective review of dermoscopic images of a consecutive series of 516 histopathologically proven melanomas collected in 6 years in Graz. Correlation of BDF with mean Breslow thickness, with presence/absence of associated benign nevus component and with the pre-operative clinico-dermoscopic diagnosis, as reported on the original histopathologic reports. Results In addition to melanoma specific criteria, 42% of melanomas showed BDF. In 12.3% cases, the benign features occupied more than the half of the lesion. The BDF typical pigment network, homogeneous pattern and regular globules/cobblestone pattern had the highest frequency. BDF were associated with relatively thinner melanomas (mean Breslow thickness of 0.51 mm). The presence of BDF was observed in 67.1% of histopathologically documented nevus-associated melanoma and in 35.7% of melanoma de novo. A pre-operative clinico-dermoscopic diagnosis of melanoma was achieved in only 54.1% of cases displaying BDF. Conclusion A significant proportion of melanomas may exhibit BDF. Clinicians should be aware of the presence of BDF in melanoma as possible diagnostic pitfall. [ABSTRACT FROM AUTHOR]

Background Leprosy is far from being eliminated with more than 200 000 new cases detected (NCD)/year. Objective Retrospective analysis between 2003 and 2009 to compare the New Case Detected Rate (NCDR) observed in Italy in the immigrant population with the NCDR of the same population in their country of origin to verify if the cases observed are those expected or not. Methods Leprosy statistics were retrieved from the Italian leprosy register and from official WHO data. Results The NCD in Italy were lower than expected, from 2003 when the expected number of NCD was 40.5 between the legally resident immigrants, but only one case was diagnosed (98% of lower from the expected), to 2009 when four NCD were diagnosed and 41 were expected (90% lower from expected). Conclusions This study points out a discrepancy between the observed and the expected cases of leprosy in Italy. Specifically, the number of NCD was less than expected for each studied year. Of course our data do not represent a validation, but only an indication of the leprosy diagnosis in Italy. Difficulty in accessing the health systems, fear of segregation, ignorance and illegal immigrant status with consequent fear of police arrest are possible explaining factors. The critical issue anyhow is the medical expertise. The role of the dermatologist is fundamental. For these reasons, there is still a need for wide spread leprosy teaching programmes. Although with few limitations, this study represents a first approach to validate the accuracy in leprosy diagnosis in Italy. [ABSTRACT FROM AUTHOR]

Background Telemedicine could be useful in countries like Italy to meet the needs of elderly patients and in particular in those in precarious general conditions, for whom travelling even short distances can pose considerable practical and economical difficulties. Objective The aim of this study was to determine the efficacy of store-and-forward teledermatology vs face-to-face consultations in elderly patients. Methods A total of 130 geriatric patients with skin diseases requiring dermatological examination were enrolled. The patients examined, consisting of 60 men (46.15%) and 70 women (53.85%), were aged between 66 and 97 years (mean age 80.58 years). Three dermatologists of the department, with equal experience took turns in face-to-face examination and teledermatology ( store-and-forward). To compare face-to-face dermatological examinations with the asynchronous store-and-forward approach of teledermatology, we considered diagnostic agreement (ICD-9 code), therapeutic agreement and concordance of diagnostic confidence. Results One hundred and fourteen of 130 patients were diagnosed with the same ICD-9 code, making a total observed agreement of 87.7% with a Cohen's κ estimated of 0.863. Agreement between therapies was 69.6% (Cohen's κ = 0.640). As it concerns diagnostic confidence, dermatologists appeared generally slightly less certain of their diagnosis by telemedicine. Conclusions Store-and-forward teledermatology can improve diagnostic and therapeutic care for skin disease in elderly who lack easy and/or direct access to dermatologists. [ABSTRACT FROM AUTHOR]

Phaeohyphomycosis is a distinct mycotic infection of the skin or internal organs caused by darkly pigmented (dematiaceous) fungi, which are widely distributed in the environment. Phaeohyphomycosis is most frequently an opportunistic infection in immunosuppressed patients (HIV, corticotherapy, transplant patients) or is frequently associated with chronic diseases and diabetes. The spectrum of the disease is broad and includes superficial infections, onychomycosis, subcutaneous infections, keratitis, allergic disease, pneumonia, brain abscesses and disseminated disease. Rarely, immunocompetent patients may be affected. We describe two new cases of subcutaneous phaeohyphomycosis in immunocompetent patients: in the first patient, the causative agent was Exophiala jeanselmei, a common cause of phaeohyphomycosis; and in the second, Cladophialophora carrionii, which could be identified by culture. Cladophialophora carrionii is mainly the aetiological agent of chromoblastomycosis and only rarely the cause of phaeohyphomycosis. The first patient was treated with surgical excision and oral itraconazole, and the second patient responded to oral itraconazole only. Lesions improved in both patients and no recurrence was observed at follow-up visits. [ABSTRACT FROM AUTHOR]

The article investigates the differences in frequency of shiny white streaks (SWS) between benign and malignant melanocytic lesions in Australasia. It states that dataset of images captured with contact-polarised light shows that SWS in melanoma are common, while benign melanocytic lesions rarely exhibit SWS. It emphasizes that SWS could be used as an additional dermoscopic feature, since SWS cannot be deemed to be a melanoma-specific criteria.

Neuroblastoma (NB) is a pediatric cancer characterized by remarkable cell heterogeneity within the tumor nodules. Here, we demonstrate that the synthesis of a pol III-transcribed noncoding (nc) RNA (NDM29) strongly restricts NB development by promoting cell differentiation, a drop of malignancy processes, and a dramatic reduction of the tumor initiating cell (TIC) fraction in the NB cell population. Notably, the overexpression of NDM29 also confers to malignant NB cells an unpredicted susceptibility to the effects of antiblastic drugs used in NB therapy. Altogether, these results suggest the induction of NDM29 expression as possible treatment to increase cancer cells vulnerability to therapeutics and the measure of its synthesis in NB explants as prognostic factor of this cancer type. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this work is to present an updated implementation of total skin electron therapy (TSET) using IAEA TRS-398 code of practice for absolute dosimetry and taking advantage of the use of radiochromic films. The optimization of quality control tests is also included. Methods: A Varian 2100 C/D linear accelerator equipped with the special procedure HDTSe- (high dose rate total skin electron mode, E=6 MeV) was employed to perform TSET irradiations using the modified Stanford technique. The commissioning was performed following the AAPM report 23 recommendations. In particular, for dual-field beams irradiation, the optimal tilt angle was investigated and the dose distribution in the treatment plane was measured. For a complete six dual-field beams irradiation, the treatment skin dose on the surface of a cylindrical phantom was evaluated by radiochromic films and the B factor which relates the single dual-field skin dose to the six dual-field skin dose was assessed. Since the TRS-398 reference conditions do not meet the requirements of TSET absolute dosimetry, GafChromic EBT films were also employed to check and validate the application of the protocol. Simplified procedures were studied to verify beam constancy in PMMA phantoms without the more difficult setup of total skin irradiation. Results: The optimized geometrical setup for dual-field beams was: Tilt angle=±19°, SSD=353 cm, and the beam degrader (200×100×1 cm3) placed at 320 cm from the source. As regards to dose homogeneity in the treatment plane, for dual-field beams irradiation, the mean relative dose value was 97%±5% (normalizing to 100% at the calibration point level). For six dual-field beams irradiation, the multiplication factor B was 2.63. In addition, beam quality, dose rate, and bremsstrahlung contribution were also suitable for TSET treatments. The TRS-398 code of practice was used for TSET dosimetry, as dose measurements performed by ionization chamber and radiochromic film agreed within 2.5%. Simplified quality control tests and baseline values were presented in order to check flatness, symmetry, and field size with radiochromic films and output and beam quality constancy with ionization chamber. Short-term reproducibility and MU linearity tests were also included. Conclusions: Commissioning parameters met the requirements of TSET treatments and the matching of AAPM guidelines with the IAEA code of practice was successful. Frequent beam performance controls can be easily performed through the presented quality assurance tests. Radiochromic dosimetry facilitated the TSET commissioning and played a major role to validate the application of TRS-398. [ABSTRACT FROM AUTHOR]

Background Palmo-plantar psoriasis (PPP) is a disabling condition that significantly impairs quality of life. PPP tends to be resistant to conventional therapies and may last for several years. Topical treatments are usually ineffective. Systemic therapy with oral retinoids and psoralen plus ultraviolet A is frequently required, although it rarely leads to remission. Study design We conducted an open-label, pilot study to evaluate treatment of PPP with efalizumab, an anti-CD11a monoclonal antibody approved for the treatment of chronic, refractory moderate to severe plaque psoriasis in adults. Methods Five patients with severe PPP received efalizumab treatment for 24 weeks. Results All five patients responded favourably by week 12 and showed further improvement at week 24 of uninterrupted therapy. Mean physician-assessed severity scores and patient-reported outcome scores improved almost 75% after 12 weeks and 90% after 24 weeks. At week 32, three patients maintained the response seen at week 24, while two patients suspended efalizumab. Conclusions Efalizumab therapy was well tolerated and effective in five patients with severe PPP, allowing a significant improvement in quality of life. Conflicts of interest None declared [ABSTRACT FROM AUTHOR]

Background: Cutaneous squamous cell carcinoma (CSCC) represents the most common malignant tumour of the feline skin. Emerging evidence suggests that the phosphatidylinositol 3‐kinase/Akt/mammalian target of rapamycin (PI3K/Akt/mTOR) signalling pathway may represent a potential target for pharmacological intervention in human and canine CSCC. Hypothesis/Objectives: The present study aimed to explore the expression pattern and status of activation of relevant signalling proteins of the PI3K/Akt/mTOR signalling pathway in feline CSCC. Methods and materials: The expression of pEGFRTyr1068, pAktSer473, pS6Ser235/236 combined with Ki‐67, and the tumour suppressor protein PTEN was evaluated by immunohistochemical analysis in 45 samples of feline CSCC, using a tissue microarray. Results: The immunodetection using phosphospecific antibodies to detect the activated forms of signalling proteins showed that the PI3K/Akt/mTOR signalling pathway is frequently activated in feline CSCCs, and may be independent of the activation of EGFR. The results also showed that PTEN expression is not significantly altered in feline CSCCs. Conclusions and clinical importance: Our study shows that the persistent activation of the PI3K/Akt/mTOR signalling pathway represents a key event in feline CSCC, pointing to this signalling pathway being a potential therapeutic target in feline patients with CSCC. [ABSTRACT FROM AUTHOR]

Background: Cutaneous infectious and inflammatory diseases may contain a significant number of CD30-positive cells, thus mimicking lymphomatoid papulosis (LyP) or anaplastic large cell lymphoma. Methods: We reviewed our cases of non-neoplastic skin conditions with large, CD30-positive cells and searched the literature for similar cases. Results: A total of 28 cases were included in the study: Milker’s nodule (n = 8), Herpes simplex virus infection (n = 7), lymphomatoid drug reaction (n = 3), molluscum contagiosum (n = 3), nodular scabies (n = 2), leishmaniasis (n = 1), syphilis (n = 1), pernio (n = 1), ruptured infundibular cyst (n = 1) and pseudolymphoma in a scar (n = 1). CD30-positive cells were often arranged in clusters and revealed both Golgi and membrane positivity, similar to what was observed in LyP and CD30+ anaplastic large T-cell lymphoma. Conclusions: Analysis of our data and of those published in the literature shows that viruses and drugs are the most common cause for occurrence of large CD30-positive cells in cutaneous pseudolymphomatous infiltrates. Arrangement of these large, CD30-positive cells in small clusters is not unique to cutaneous CD30-positive lymphomas, and in many cases a precise diagnosis can be made only upon accurate clinicopathological correlation or using ancillary methods such as polymerase chain reaction analysis for viral DNA. [ABSTRACT FROM AUTHOR]

Background: CD4+/CD56+ hematodermic neoplasm (HN) (blastic natural killer (NK)-cell lymphoma) is a rare entity characterized by dense, monomorphous infiltrates of medium-sized cells with blastic appearance and a characteristic immunophenotype (positivity for CD4, CD56 and CD123). The combination of CD4 and CD56 positivity is thought to be so striking that it has been used to name this entity. Methods: Three cases of HN with ambiguous phenotypic profile were included in this study. In all cases, phenotypic, molecular and in situ hybridization studies were carried out. Results: All three cases showed an aberrant phenotype with negativity for CD4. Conclusions: CD4-negative or CD56-negative cases of HN have been rarely reported in the literature and represent a diagnostic problem. Our three cases confirm that CD4 is not always expressed in these neoplasms. The term ‘CD4+/CD56+ hematodermic neoplasm’ adopted in the World Health Organization–European Organization for Research and Treatment of Cancer classification of cutaneous lymphomas may be misleading and should probably be revised in the light of all data published in the literature. [ABSTRACT FROM AUTHOR]

Background: Primary cutaneous anaplastic large T-cell lymphoma (PCALCL) is a well-defined entity with prognostic differences from the nodal counterpart [nodal anaplastic large cell lymphoma (NALCL)]. Several histological variants of NALCL have been characterized (common, lymphohistiocytic and small cell). However, studies on morphological variants of PCALCLs are lacking. Methods: We analyzed retrospectively the clinicopathologic features of 66 biopsies from 47 patients (M : F = 27 : 20; median age: 53 years; mean age: 51.8 years; range: 14–82) with PCALCL, in order to better characterize the spectrum of this unusual neoplasm. Results: The ‘common variant’ was the most frequent (40.4%). In contrast to NALCL, in PCALCL, marked reactive infiltrates are more commonly present. In fact, 26 cases were classified as ‘inflammatory type’ (15 cases) and ‘lymphohistiocytic’ (11 cases). Concerning the predominant cell morphology, large anaplastic cells (33%) were almost as frequent as large pleomorphic (36%) and small to medium-sized cells (26%). We reported for the first time in the skin 2 rare cases with the predominance of large cells with a ‘signet-ring’-like appearance. Epidermotropism and presence of eosinophils were found in a proportion of cases in all PCALCL variants. Conclusions: PCALCL is characterized by variable histopathological presentations and a broad cytomorphologic spectrum. [ABSTRACT FROM AUTHOR]

In THP-1 monocytes, cellular proteasome inhibition by ritonavir or ALLN is associated with increased production of oxidative stress. Both compounds produced comparable amounts of oxidative stress; however, normalization by α-tocopherol occurred solely after inhibition by ritonavir, and not by ALLN. Similar to that, α-tocopherol could normalize the reduced formation of 3-nitrotyrosine-modified proteins only after ritonavir treatment. In the absence of any proteasome inhibitor, intrinsic cellular proteasome activity was not modulated by α-, β-, and γ-tocopherols; however, δ-tocopherol, α-tocotrienol, and α-tocopheryl phosphate could significantly inhibit cellular proteasome activity and increased the level of p27Kip1 and p53. Since oxidative stress was reduced by α-tocopherol only after proteasome inhibition by ritonavir and not by ALLN, it is concluded that, in this experimental system, α-tocopherol does not act as an antioxidant but interferes with the inhibitory effect of ritonavir. [ABSTRACT FROM AUTHOR]

Background/purpose: Polymorphic light eruption (PLE) is a common photodermatosis of potential autoimmune origin, and an overlap with lupus erythematosus (LE) has been described. Plasmacytoid dendritic cell (PDC)-induced expression of interferon (IFN)-α has been found to be present in LE skin lesions and plays a pivotal role in the pathogenesis of LE by promoting autoimmunity. We therefore asked whether PDCs may also be involved in the pathogenesis of PLE and searched for those cells [which can be identified by their high levels of interleukin (IL)-3 receptor α chain (CD123), combined with other cell markers such as CD68] in skin lesions. Methods: Paraffin-embedded biopsy specimens from a total of 27 patients with clinically and histologically confirmed PLE (nine women, mean age 32.7 years, age range 18–43), LE (seven women, four men, CCLE: n=4, SCLE: n=2, lupus tumidus: n=5, mean age 48.5 years, age range 41–65) or psoriasis (four women, three men, mean age 43.3 years, age range 19–54) (as control group) were analyzed by immunohistochemical CD68/CD123 double staining. Quantification of the immunohistochemical staining was performed by visual cell counting of CD68−/CD123+, CD68+/123–, and CD68+/CD123+ cells separately in the epidermis and dermis of the samples in at least 10 random fields per sample at × 400 microscopic magnification by two of the investigators in a blinded fashion. Results: Microscopic examination of the immunohistochemically stained sections revealed that CD68+/CD123+ cells were present in most specimens obtained from LE [10/11 (91%)] and psoriasis [6/7 (86%)] patients but not at all in those obtained from PLE patients. Quantification and statistical analysis of the dermal infiltrate revealed that CD68+/CD123+ cells were present at a mean±SEM field density of 5.6±1.3 in LE, 1.6±0.6 in psoriasis but totally absent in PLE ( P=0.0010 vs. LE, P=0.0135 vs. psoriasis by an unpaired Student's t-test). Conclusion: The results confirm the potential significance of PDCs in LE and psoriasis, however the absence of PDCs in PLE contradicts the hypothesis that these cells might play a role in the latter disease. [ABSTRACT FROM AUTHOR]

Background Telemedicine is the practice of healthcare using interactive processes of communication to facilitate healthcare delivery, including diagnosis, consultation and treatment, as well as education and transfer of medical data. The aim of teledermatology, just as telemedicine, is to promote best practice procedures and to improve the consistency and competence of health care. Aim To investigate the diagnostic additive value of second opinion teleconsulting in patients with challenging dermatoses, among dermatologists working in two different dermatology departments. Setting Thirty-three cases of patients with challenging inflammatory and neoplastic skin diseases at the University of L’Aquila Department of Dermatology were sent for teleconsultation to the Department of Dermatology, Medical University of Graz, Austria. Methods All cases were selected in the outpatient service in L’Aquila. After face-to-face consultation with a local colleague had been completed, images were sent using a store-and-forward (SAF)-based system ( ) to Graz. Histopathological examination together with follow-up of the patient represents the diagnostic gold standard for this study. Results Telediagnosis was correct in 26 of 33 (78.8%) cases. Sixteen of 33 cases (48.5%) had already been diagnosed face-to-face by at least one of the two dermatologists in L’Aquila. In 10 of 33 cases (30.3%), the correct diagnosis was made in teleconsultation only. Conclusions Second opinion teleconsulting may represent an additive value in the diagnosis of numerous challenging inflammatory and neoplastic skin diseases. It may be particularly useful as a best practice model for smaller departments in order to discuss and/or to confirm diagnoses and also for the management of patients with unusual difficult dermatoses. [ABSTRACT FROM AUTHOR]

Background: Subcutaneous T-cell lymphoma (STCL) represents a controversial entity and a confused concept in the field of cutaneous T-cell lymphomas (CTCLs). Recently, α/β+/CD8+ STCL has been recognized by the new World Health Organization (WHO)–European Organization for Research and Treatment of Cancer (EORTC) classification of primary cutaneous lymphomas as a distinct entity in the group of CTCLs. Observations: We reviewed a series of 53 biopsies from 26 patients (F : M = 19:7; median age: 48; range 18–87) of cutaneous B- and T-cell lymphomas characterized by prominent involvement of the subcutaneous tissue. We could classify our cases according to the following seven categories – (i) STCL: n = 16; (ii) extranodal NK/T-cell lymphoma, nasal type: n = 2; (iii) cutaneous γ/δ T-cell lymphoma: n = 2; (iv) anaplastic CD30+ large T-cell lymphoma: n = 1; (v) diffuse large B-cell lymphoma, secondary cutaneous: n = 3; (vi) lymphoplasmacytic lymphoma, secondary cutaneous: n = 1; (vii) specific cutaneous manifestations of myelogenous leukemia: n = 1. Conclusions: We demonstrated the protean nature of lymphomas with prominent involvement of the subcutaneous fat tissues. The term STCL should be restricted to a homogeneous group of cases characterized morphologically by an exclusive involvement of subcutaneous tissues, immunohistochemically by a T-cytotoxic α/β phenotype, and biologically by a relatively good prognosis. [ABSTRACT FROM AUTHOR]

A 10-year-old male Briard dog was presented because of listlessness, abnormal gait, fever, inappetence, and seizures. A non-pigmented growth was observed in the ventral quadrant of the left iris. Thoracic radiographs revealed multiple pulmonary metastases and the owner opted for killing. On necropsy, lung masses and nodules in left iris, right adrenal medulla, and brain were detected. Histologically the primary tumour was diagnosed as pulmonary adenocarcinoma with predominant solid pattern. Metastases to regional lymph nodes, uvea, adrenal medulla, and brain were recognized. The metastatic behaviour resembled that occurring in humans. To the authors’ knowledge, this is the first report of a pulmonary adenocarcinoma with metastasis to the uvea in a dog. [ABSTRACT FROM AUTHOR]

Down syndrome (DS) is the most common genetic disorder with mental retardation and is caused by trisomy 21. By the age of 40 years, virtually all adults with DS have sufficient neuropathology for a diagnosis of Alzheimer's disease (AD), which is characterized by accumulation of amyloid-beta in senile plaques and formation of neurofibrillary tangles. Amyloid-beta derives from a longer precursor protein, APP, whose gene maps to chromosome 21. In DS, the early appearance of senile plaques is commonly associated with the presence of a third copy of the APP gene. Here we show DS brains and trisomic fibroblasts in which APP is not overexpressed, compared to euploid controls, challenging the notion that the widespread amyloid-beta deposits, consistently found in DS individuals, result from an extra copy of APP. iubmb Life , 58: 103–106, 2006 [ABSTRACT FROM AUTHOR]

Innovation in manufacturing is driven by the globalization of competition, differentiation in demand, the shortening of the product lifecycle and the managerial innovations adopted by companies in response to the environment. Innovation has generated the new modular production system that allows greater product variety and variability. This new modular pattern in manufacturing determines a change in the priority list concerning human factors. Cognitive cooperation among all stakeholders in the manufacturing process, from suppliers to managers and workers, becomes the new focal point that must be developed and supported to ensure excellent performance of the modular factory and reasonable margins of identification for the persons performing the processes. The authors argue that both change management practices of a prescriptive type and those based solely on commitment are bound to fail in the medium term, as they are unable to address the autogenous character of change. If long-lasting change is to be generated, managers must understand and define the desires, intentions, and values denoting the subjective and collective identities of communities of persons at work; they must not be interested in direct self-promotion of that particular type of change that fits in with their own original characters and their history. This pragmatic principle applies both to the internal processes of the modular factory and to those external processes that link the company to its suppliers. In sum, it is the authors' view that the new horizons of human factors in manufacturing no longer rely on the best match between people, technologies, and the organization, as the capability to create cognitive spaces to construct new meanings. © 2005 Wiley Periodicals, Inc. Hum Factors Man 15: 403–419, 2005. [ABSTRACT FROM AUTHOR]

The diagnosis of lupus erythematosus panniculitis (LEP) may be very difficult in cases in which involvement of the subcutaneous fat is the only manifestation of the disease. The main differential diagnosis is subcutaneous panniculitis-like T-cell lymphoma (SPTCL).We performed a retrospective study reviewing the histopathologic features of 11 biopsy specimens from nine patients with LEP (M : F = 2 : 7; median age: 48 years; range: 20–71 years).Histopathologically, all biopsies revealed a lobular panniculitis, with concomitant septal involvement in 82% of them. Dermal changes included the presence of superficial and deep infiltrates (82%) and mucin deposition (73%). The majority of cases (73%) presented also some form of epidermal involvement. The subcutaneous infiltrate was composed of lymphocytes in all cases, admixed with plasma cells in 91% of cases. Lymphoid follicles with reactive germinal centers were detected in 45% of cases. Immunohistochemistry showed a predominance ofα/β-T-helper and cytotoxic lymphocytes in 80% of cases admixed with B lymphocytes. The polymerase chain reaction analysis of the T-cell receptor (TCR)-γ gene showed a polyclonal smear in all cases.Our study shows that the most useful histopathologic criteria for distinguishing LEP from SPTCL are the presence of involvement of the epidermis, lymphoid follicles with reactive germinal centers, mixed cell infiltrate with prominent plasma cells, clusters of B lymphocytes, and polyclonal TCR-γ gene rearrangement.Massone C, Kodama K, Salmhofer W, Abe R, Shimizu H, Parodi A, Kerl H, Cerroni L. Lupus erythematosus panniculitis (lupus profundus): Clinical, histopathological, and molecular analysis of nine cases. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate gene expression in Alzheimer's disease (AD), the most common form of senile dementia. We utilized the microarray technology to simultaneously compare the expression profile of 12,000 human genes in cerebral cortex of AD and normal aging. To identify gene expression related to neurodegeneration, beside the presence of amyloid deposition, we used control brains with abundant amyloid plaques, derived from cognitively normal elderly subjects. The microarray analysis indicated that 314 genes were differentially expressed in AD cerebral cortex, with differences greater than 5 folds in 25 genes. RT-PCR performed on a selected group of genes confirmed the increased expression of the interferon-induced protein 3 in AD brain. This protein, which is highly inducible by both type I and type II interferons, was not previously associated with the neurodegenerative disease. IUBMB Life, 56: 349-354, 2004 [ABSTRACT FROM AUTHOR]