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Purpose Visceral leishmania (VL) and HIV were related since the beginning of AIDS era but the impact of HAART has completely changed the pattern. Aim of the study is to describe the current presentation of this opportunistic infection. Methods Demographics, clinical, laboratory and therapeutic findings were recorded in patients (pts) enrolled in the Ligurian registry for VL from January 1st 2007 to December 31st 2010. From these data we obtained the HIV+features. Statistical analysis was performed using: STATA 11.0 and SPSS software 13. Statistical significance was defined as a P value<0.05. Summary of results A total of 65 episodes in 55 pts (36 adult) were accumulated: median age 48.7 years (yrs) in adults (37.5 months in pediatric pts). All children were immunocompetent (ICC), adults included both ICC (17) and immunosuppressed (19) (ISS) pts. HIV was the leading cause of immunosuppression (10-59%) all pts. belonged to CDC stage C and they sustained 15 cases of infection; 4 were not on HAART and 4 on a failing regimen. Mean age in HIV +pts was 38 yrs, average CD4+count and HIV RNA at first diagnosis were respectively 135/l±101 and 6,974×104 cp/ml (0-2.8×105). No significant CD4 r differences at first diagnosis were present among who would not recur compared to those for whom a VL recurrence was observed. Main clinical presentations were: Fever (F)+hepatosplenomegaly 8, F+lymphoadenoathy 2, F+pancytopenia 2, thrombocytopenia 2, other 1. Detection of urinary antigen and serology (IFAT) were the most frequently used diagnostic tools (respectively in 14/15 and 11/15 pts). Bone marrow detection of intracellular parasites (Giemsa) was performed only in 4/15 cases. Liposomal amphotericin B was the most frequently (98.2% of cases) prescribed drug with 100% clinical cure. VL relapses (n°5) represented a crucial finding: they occurred in 3 pts and time to relapse presented a significant difference among ICC and ISS; CD4+cell numbers at VL recurrence were not different compared to those for the pts at baseline. Three deaths were reported, accounting for significant (15.8%) mortality. Conclusions The main findings can be summarized as follows: clinical presentation among HIV pts is heterogeneous with frequent recurrence and remarkable mortality. Moreover, the use of both serology and urinary antigens detection for diagnostic purposes allows a reliable performance and could be very useful in pts not eligible for bone marrow aspiration. [ABSTRACT FROM AUTHOR]

Chronic venous disease (CVD) is a common condition with major health consequences that is associated with poor long-term prognosis, significant socioeconomic impact, disabling symptoms and reduced quality of life. To provide practical guidance for diagnosis and management of CVD, a Delphi panel of 5 experts in steering committee and 28 angiologists/vascular surgeons met with the major aim of providing a supplement for established national and international guidelines. A total of 24 statements were voted upon in two rounds, of which consensus was reached on 22 statements, indicating a high level of overall agreement. Consensus was reached on 7 of 8 statements relative to diagnosis (CEAP classification, diagnostic tools, QoL assessment, diagnostic imaging) and on 15 of 16 statements on management (conservative treatments, compressive therapy, pharmacological therapy, surgical treatment). The results of the consensus reached are discussed herein from which it is clear that diagnostic and management approaches utilising personalised therapies tailored to the individual patient should be favoured. While it is clear that additional studies are needed on many aspects of diagnosis and management of CVD, the present Delphi survey provides some key recommendations for clinicians treating CVD that may be useful in daily practice., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Aim of this study was to plot height, weight and height velocity values of primary school civic population of Portici and Ercolano, Campania towns, on Tanner's charts in order to verify the overlapping of percentile distribution. On May 1994 height and weight were measured in 3504 children (1735 boys and 1769 girls, aged 5.4-16.1 years, mean age = 8.6 years) from the 1st, 2nd and 5th year of primary schools in Portici and Ercolano. One year later, on May 1995, we remeasured and reweighed 1583 (781 boys and 802 girls, aged 6.4-14.2 years, mean age = 9.6 years) out of total children and we calculated height velocity (HV). The height and weight profiles of our population sample show that children in Portici and Ercolano are taller and fatter than those measured by Tanner and Whitehouse 25-30 years ago. The calculation of body mass index (BMI) confirmed that 30% of total children were obese. Furthermore, the evaluation of one-year HV revealed a clear improvement of linear growth. Our data suggest that Tanner and Whitehouse charts should be updated, and it should be useful to elaborate also height, weight and HV standards derived from present-day population.