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Social media platforms have become integral to healthcare communication, particularly in dermatology, where visual assessment and patient education are paramount. While platforms like Instagram, Facebook, and Twitter offer significant opportunities to raise awareness about skin health, promote preventive measures, and encourage early detection of dermatological conditions, the unregulated dissemination of health information poses substantial risks due to misinformation. In response to these challenges, the Italian Association of Hospital Dermatologists (ADOI) has launched a nationwide survey titled "Use of Social Media by Dermatology Professionals: Impact on Public Awareness, Appropriateness of Information, and Correctness of Prevention Messages—An Italian Survey". This initiative aims to analyze social media usage among dermatology professionals, evaluate its impact on public awareness and preventive behaviors, examine the appropriateness and correctness of shared information, identify challenges and opportunities, and assess the need for official guidelines supported by ADOI. The importance of this study lies in its potential to enhance public health outcomes by ensuring that information shared on social media is accurate, evidence-based, and ethically presented. By collecting data-driven insights, the survey seeks to inform the development of professional guidelines, promote responsible digital engagement, and improve patient education and outcomes. Addressing ethical and privacy concerns is also a key objective. The participation of dermatology professionals is crucial in shaping the future of dermatological care and public health education. This initiative represents a critical step toward improving the quality of dermatological information available on social media and ultimately enhancing patient outcomes through better-informed patients and earlier interventions.

Background: Severe burn injuries significantly challenge acute medical care, particularly in resource-limited environments. Current predictive scoring systems, often impractical and adult-focused, neglect crucial aspects like mechanical ventilation and length of hospital stay (LOS). Methods: This study analyzed 2,618 severe burn patients, developing new predictive models for survival, mechanical ventilation, and LOS, based on promptly accessible factors applicable in any setting. Results: We observed significant seasonality and clear age- and gender-specific patterns, highlighting the necessity for targeted interventions. We developed and publicly released new predictive models for mortality, mechanical ventilation, and LOS for both adult and pediatric populations. Discussion: Targeting deficiencies in existing scoring systems, this study potentially advances acute burn management, with a particular focus on resource-limited settings. It provides crucial insights into the epidemiology, etiology, and prognostic factors of severe burn injuries, encapsulated in 10 actionable points. We also present an innovative freely accessible online assessment tool: https://burn-scores.com. Conclusion: By bridging gaps in current scoring methodologies and improving acute phase management, our research offers insights to improve clinical outcomes for severe burn patients globally. The integration of tailored predictive models and technology-driven solutions, especially relevant in resource-constrained settings, represents a major stride in enhancing the quality of burn care.

Objective. This review examines skin manifestations in women with spondyloarthritis, with a particular focus on psoriatic arthritis (PsA) and associated psoriasis. Methods. A narrative review of the bibliography was conducted using the main databases (PubMed, Scopus, EMBASE). Results. The review showed that the clinical course of PsA and psoriasis in women is influenced by hormonal fluctuations that occur at different stages of life, such as menstruation, pregnancy, postpartum, and menopause. Gender differences in the epidemiology of PsA and psoriasis are discussed and attributed to biological, hormonal, and environmental differences. The role of estrogen in modulating immune responses and its impact on the severity of PsA and psoriasis are reviewed. Special emphasis is placed on the psychosocial impact of visible skin lesions on women’s quality of life and fertility problems associated with psoriasis. Treatment strategies are also taken into account, favoring personalized approaches that consider the safety of treatments during pregnancy and breastfeeding. Conclusions. The review highlights the importance of a holistic and gender-sensitive approach to the management of PsA and psoriasis in women, promoting the integration of physical treatment with support for emotional well-being.

Abstract Atopic dermatitis (AD) is an inflammatory chronic recurrent skin condition that causes recurrent, itching eczematous lesions with a great impact on the quality of life of patients. We describe a case series of five adult patients with severe AD (Eczema Area Severity Index [EASI] ≥24) treated with tralokinumab. Tralokinumab is a monoclonal antibody that specifically binds IL‐13 with high affinity, blocking the interaction of IL‐13 with its specific receptors and neutralising its biological activity. Tralokinumab was recently approved for the treatment of moderate‐to‐severe AD in adults. In these patients, several conventional topical and systemic treatments (such as UV‐B phototherapy, systemic cyclosporine and dupilumab) had been previously tried. Three patients reported severe conjunctivitis during the previous treatment with dupilumab and one patient had not a good clinical response to dupilumab, as this treatment was stopped. Therefore, treatment with tralokinumab as a subcutaneous injection at an initial dose of 600 mg followed by 300 mg administered every other week was started. The severity of AD was assessed at baseline, Week 12 and Week 20 using several clinical scores (EASI, SCOring Atopic Dermatitis, Itch score, Dermatology Life Quality Index). All patients achieved clinical remission with a significant clinical improvement of itching and eczema in all body areas, assessed with several clinical scores; furthermore, no adverse events were reported during the observation period. During the treatment with tralokinumab, one patient was also infected by the SARS‐CoV‐2 virus, reporting mild clinical symptoms of the upper respiratory tract. These symptoms spontaneously resolved in 2 days with no medications. Although additional real‐world data are certainly required about the efficacy and safety of tralokinumab, the prospects of new drugs for the long‐term treatment of moderate‐to‐severe AD represent a great opportunity for these patients, which had very few therapeutic options until now.

This study, employing an interim analysis, investigates the effects of the Dermamecum protocol, a structured educational and tailored approach that stratifies ostomy patients into risk paths (green, yellow, red) based on pre-operative and post-operative characteristics. The green path indicates a low risk of peristomal skin complications (PSCs), focusing on sustaining healthy behaviours and basic stoma care. The yellow path represents a moderate risk, emphasizing the need for patients to self-monitor and recognize early signs of complications. The red path corresponds to high risk, requiring stringent monitoring and immediate access to healthcare support. The study aims to reduce PSCs and improve patient outcomes. Methods include the stratification of 226 patients, with significant differences in gender distribution, BMI categories, and stoma types across the paths. Results show an occurrence rate of PSCs of 5.9% in all risk paths (5.7% green path, 4.7% yellow path, and 7.9% red path, p = 0.685), significantly lower than the median rate of 35% reported in the literature. Multiple correspondence analysis validated the stratification, with distinct clusters for each path. Poisson regression models in the exploratory framework of an interim analysis identified male gender as the only significant predictor of PSCs, indicating the need for gender-specific interventions. The findings suggest that the Dermamecum protocol effectively reduces early PSCs, providing a foundation for further research.

Keratitis-ichthyosis-deafness syndrome (KID) is a rare genetic disorder characterized by the triad of hyperkeratosis, ichthyosis, and congenital prelingual sensorineural deafness, with less than 100 cases described in the literature. In addition to many other extra-cutaneous manifestations, these patients are burdened by two principal increased risk factors involving the skin: the risk of developing infections and the risk of developing malignant skin tumors, especially Squamous Cell Carcinoma and Trichilemmal tumors. We present the case of a 7-year-old girl with a unique genetic variant described to date, who developed 4 dyskeratotic neoformation. Since the dermatoscopic examination was not sufficient to exclude malignancy, excisional and punch biopsies were used. Nonetheless, healing was challenging, with wound dehiscence and infection onset. Ad hoc wound care management resorting to negative pressure therapy and advanced medical honey-based dressings was necessary to achieve complete wound healing.

The aim of this research is to the potential for cybercrime and its prevention in foreign official travel approval letters. The research method used is normative juridical. The data collection technique is library research. The data analysis technique is descriptive qualitative which is used in the form of an interactive analysis model. The research results show that the potential for cybercrime in foreign official travel approval letters includes hacking, identity theft, data breaches, phishing, spamming, cyber vandalism, virus writers, XML injection, security configuration errors. To prevent cybercrime, the simple web application or https://simpel.setneg.go.id has data security, namely security testing by the state cyber and password agency, a captcha feature on the simple web, one time password feature on simple phones, application of certified digital signatures. The conclusion of this research is that the potential for cybercrime in overseas official travel approval letters is increasing. Prevention solutions can include educating users, using a hacker perspective, patch systems, policies, Intrusion Detection Systems bundled with Intrusion Prevention Systems, antivirus firewalls. Legal regulatory steps to support the implementation of cybercrime prevention solutions, namely Law No. 11 of 2008 concerning ITE and PP No. 82 of 2012 concerning the implementation of Electronic Systems and Transactions.

Abstract Background Lichen sclerosus is a chronic, progressive, inflammatory skin disease that presents unique challenges, particularly in the pediatric population, where limited data exist regarding its manifestation and optimal management. This retrospective observational monocentric study aims to provide insights into the clinical characteristics and therapeutic strategies employed, in a cohort of children and adolescents with genital lichen sclerosus. Methods A comprehensive analysis was conducted involving a cohort of 60 pediatric patients ranging from 1 to 15 years old, all diagnosed with lichen sclerosus. These cases were referred to the Pediatric Dermatology Regional Center of the University of Padua, Italy, between January 2018 and January 2022. Moreover, we propose a treatment protocol that showed beneficial outcomes in all of our patients. Specifically, the initial use of mid-potency topical corticosteroids has proven effective in addressing severe acute flares. Following this acute phase, transitioning to long-term treatment with topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, has demonstrated effectiveness in maintaining remission of the disease and also shown efficacy in treating mild cases. The therapeutic effectiveness was assessed by considering various clinical aspects, including erythema, paleness, skin erosions, and specific symptoms such as itching, burning, and pain. Results Erythema emerged as the predominant clinical sign, reported in 43 (78.3%) patients, followed by paleness, reported in 17 (28.3%) patients. Pruritus was observed in 25 girls (58.1% of females) and 2 boys (11.8% of males), while pain and burning sensations were predominantly reported in female children. Among females, we observed a higher prevalence of cutaneous comorbidities, such as atopic dermatitis, psoriasis, alopecia areata, and linear scleroderma, as opposed to autoimmune systemic diseases, that were more prevalent in males. Regarding therapeutic approaches, 21 (35.0%) patients applied topical corticosteroids, 28 (46,7%) applied topical tacrolimus and 21 (35,0%) applied topical pimecrolimus. All treated patients experienced notable benefits following the initiation of treatment proposed by our protocol. Conclusions This study provides further insights into the clinical presentation and management of lichen sclerosus in the pediatric population, shedding light on potential therapeutic pathways for optimizing patient outcomes in this specific demographic. The proposed protocol appears to be a promising strategy, especially when the onset of the disease occurs during childhood.

Psoriasis is a common chronic skin disease mainly located in areas of friction. Psoriasis of the lips as an exclusive presentation is rare and often misdiagnosed. Different anti-psoriatic therapies have been proposed, but the literature is limited to case studies with partial results. Biologic therapies have revolutionized the management of many dermatologic conditions, including psoriasis, and they are approved for pediatric use. We report the case of a 14-year-old boy with a 2-year history of white-yellowish scaling lesions on his lips, without intraoral involvement. Lip biopsy showed a psoriasiform pattern. Treatment with adalimumab 40 mg every other week was started, and after 6 months of therapy, we obtained a complete remission of the patient’s lip psoriasis.

Currently, there are a few detailed guidelines on the overall management of children and adolescents with moderate-severe atopic dermatitis. AD ​​is a complex disease presenting with different clinical phenotypes, which require an individualized and multidisciplinary approach. Therefore, appropriate interaction between primary care pediatricians, pediatric allergists, and pediatric dermatologists is crucial to finding the best management strategy. In this manuscript, members of the Italian Society of Pediatric Allergology and Immunology (SIAIP), the Italian Society of Pediatric Dermatology (SIDerP), and the Italian Society of Pediatrics (SIP) with expertise in the management of moderate-severe atopic dermatitis have reviewed the latest scientific evidence in the field. This narrative review aims to define a pathway to appropriately managing children and adolescents with moderate-severe atopic dermatitis.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease that negatively impacts the quality of life and work productivity of patients. Objectives: We sought to evaluate the real-world burden of AD patients in Italy. Methods: This sub-analysis of the MEASURE-AD multicountry study conducted between December 2019-2020 included patients diagnosed with moderate-to-severe AD eligible for receiving systemic therapy in the previous 6 months. During a single visit, physician and patient-reported questionnaires were used. Results: A total of 118 adult patients were enrolled and 57.6% (N = 68) of patients had moderate-to-severe AD at the time of enrolment according to the Eczema Area and Severity Index.Sleep disorders interfered with daily function in the previous week in 58.5% (N = 69) of patients, pru-ritus was severe in 50% (N = 59) and 42.4% (N = 50) reported a flare lasting >7 days in the previous 6 months.According to the Dermatology Quality of Life Index, 37.3% (N = 44) of patients reported a severe impact of AD and approximately 10% had clinical depression/anxiety. Current drug therapy was considered inadequate in controlling AD in 26.3% (N=31) of patients.Work activity impairment was 38.6±31.7% and monthly AD-related expenses were 148.6±134.6 Euros per patient. Conclusions: This real-life study documents a high burden of disease in patients with moderate-severe AD in Italy.

Abstract is missing (Short communication)

Abstract Impetigo herpetiformis (IH) is a rare variant of pustular psoriasis with typical onset during the third trimester of pregnancy; it is characterized by erythematous plaques lined with sterile pustules and sometimes there may be systemic involvement. On the other hand, eczema herpeticum (EH) is defined as a disseminated skin infection by herpes simplex virus type 1, which mainly affects patients characterized by an impaired integrity of the skin barrier, mostly atopic dermatitis. We report the case of a 30‐year‐old woman, primigravida at 28 + 3 weeks of gestation, who after asymptomatic severe acute respiratory syndrome coronavirus 2 infection for about 7 days presented to the emergency room with a burning and itching rash on the trunk and limbs. She reported a long‐standing history of atopic dermatitis and recurrent herpetic eruptions. The diagnosis of EH was made and systemic therapy was set with excellent results. A few days later, the patient developed a pustular rash in the areas previously affected by EH, with histologic features of IH. A relation between EH and IH is thus suggested.

Abstract We present a case of sirolimus‐induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in a stem cell transplant patient. Sirolimus is an immunosuppressive drug that inhibits the mammalian target of rapamycin (mTOR) pathway. A 24‐year‐old male with a history of acute lymphoblastic leukemia (ALL) underwent testicular extraction followed by hematopoietic stem cell transplantation (HSCT). He presented with pruritic eczematous lesions, which were initially treated with topical steroids. However, he later developed diffuse xerosis, fever, chills, generalized edema, weight gain, eosinophilia, and leukopenia. Skin biopsy showed spongiotic dermatitis with eosinophils, suggesting a drug or atopic reaction. Investigations ruled out infections, and the RegiSCAR score indicated drug reaction syndrome with eosinophilia and systemic symptoms (DRESS). Sirolimus, an immunosuppressive drug, was suspected as the cause. Sirolimus was discontinued, and oral steroids were initiated. After 3 weeks of therapy, the patient showed improvement with resolution of symptoms. Although no cases of sirolimus‐induced DRESS syndrome have been reported, allergic reactions with eosinophilia induced by everolimus have been documented. In our case, the patient's history characterized by stem cell transplantation and multiple immunosuppressive therapies may have contributed to the development of DRESS syndrome after beginning sirolimus therapy. This case may be the first evidence of sirolimus‐induced DRESS syndrome in a stem cell transplant patient.

This comprehensive review offers a detailed look at atopic dermatitis (AD) treatment in Italy, focusing primarily on the use of biologics and small molecules. In response to advancing knowledge of AD's causes and treatments, there's a global need for updated guidelines to provide physicians with a more comprehensive clinical perspective, facilitating personalized treatment strategies. Dupilumab, a groundbreaking biologic, gained approval as a significant milestone. Clinical trials demonstrated its ability to significantly reduce AD severity scores, with an impressive 37% of patients achieving clear or nearly clear skin within just 16 weeks of treatment. Real-world studies further support its efficacy across various age groups, including the elderly, with a safety profile akin to that of younger adults. Tralokinumab, a more recent approval, shows promise in clinical trials, particularly among younger populations. However, its real-world application, especially in older individuals, lacks comprehensive data. JAK inhibitors like Upadacitinib, baricitinib, and abrocitinib hold substantial potential for AD treatment. Nevertheless, data remains limited for patients over 75, with older adults perceived to carry a higher risk profile. Integrated safety analyses revealed individuals aged 60 and above experiencing major adverse cardiovascular events and malignancies, underscoring the need for cautious consideration. While these therapies offer promise, especially among younger patients, further research is essential to determine their safety and efficacy in various populations, including pediatric, geriatric, and those with comorbidities. This review highlights the evolving landscape of AD treatment, with biologics and small molecules emerging as potent tools to enhance the quality of life for AD-affected individuals.

Specific immune suppression types have been associated with a greater risk of severe COVID-19 disease and death. We analyzed data from patients >17 years that were hospitalized for COVID-19 at the “Fondazione IRCCS Ca′ Granda Ospedale Maggiore Policlinico” in Milan (Lombardy, Northern Italy). The study included 1727 SARS-CoV-2-positive patients (1,131 males, median age of 65 years) hospitalized between February 2020 and November 2022. Of these, 321 (18.6%, CI: 16.8–20.4%) had at least one condition defining immune suppression. Immune suppressed subjects were more likely to have other co-morbidities (80.4% vs. 69.8%, p

Understanding the aberrant transcriptional landscape of neuroblastoma is necessary to provide insight to the underlying influences of the initiation, progression and persistence of this developmental cancer. Here, we present chromatin immunoprecipitation sequencing (ChIP-Seq) data for the oncogenic transcription factors, MYCN and MYC, as well as regulatory histone marks H3K4me1, H3K4me3, H3K27Ac, and H3K27me3 in ten commonly used human neuroblastoma-derived cell line models. In addition, for all of the profiled cell lines we provide ATAC-Seq as a measure of open chromatin. We validate specificity of global MYCN occupancy in MYCN amplified cell lines and functional redundancy of MYC occupancy in MYCN non-amplified cell lines. Finally, we show with H3K27Ac ChIP-Seq that these cell lines retain expression of key neuroblastoma super-enhancers (SE). We anticipate this dataset, coupled with available transcriptomic profiling on the same cell lines, will enable the discovery of novel gene regulatory mechanisms in neuroblastoma.

Glucocorticoids (GCs) are a central component of therapy for patients with T cell acute lymphoblastic leukemia (T-ALL), and although resistance to GCs is a strong negative prognostic indicator in T-ALL, the mechanisms of GC resistance remain poorly understood. Using diagnostic samples from patients enrolled in the frontline Children's Oncology Group (COG) T-ALL clinical trial AALL1231, we demonstrated that one-third of primary T-ALLs were resistant to GCs when cells were cultured in the presence of IL-7, a cytokine that is critical for normal T cell function and that plays a well-established role in leukemogenesis. We demonstrated that in these T-ALLs and in distinct populations of normal developing thymocytes, GCs paradoxically induced their own resistance by promoting upregulation of IL-7 receptor (IL-7R) expression. In the presence of IL-7, this augmented downstream signal transduction, resulting in increased STAT5 transcriptional output and upregulation of the prosurvival protein BCL-2. Taken together, we showed that IL-7 mediates an intrinsic and physiologic mechanism of GC resistance in normal thymocyte development that is retained during leukemogenesis in a subset of T-ALLs and is reversible with targeted inhibition of the IL-7R/JAK/STAT5/BCL-2 axis.

Abstract Background Pediatric Mastocytosis is a rare and heterogeneous disease, characterized by accumulation of mast cells in the skin (Cutaneous Mastocytosis) and/or, less frequently, in other organs, mainly liver, spleen, bone marrow, lymph nodes and gastrointestinal tract (Systemic Mastocytosis). Patients affected by Systemic Mastocytosis show symptoms caused by a massive release of mast cell mediators: itching, flushing, abdominal pain, generalized weakness, fatigue and neuropsychiatric disorders. Moreover, children with Systemic Mastocytosis are at greater risk of anaphylactic/anaphylactoid reactions, often poorly controlled by the conventional therapy with antihistamines, mast cells stabilizers and steroids. As a result, children affected by Systemic Mastocytosis have a poor quality of life and suffer the consequence of prolonged steroidal treatment. Case presentation A child with Systemic Mastocytosis and severe symptoms, refractory to symptomatic and steroidal therapy, has been successfully treated with Omalizumab, an anti-IgE monoclonal antibody usually employed in allergic patients with severe asthma and orticaria. The onset of clinical benefit of Omalizumab therapy was extraordinarily rapid, but proved to be strictly dependent on drug administration. The child has become completely and steadily asymptomatic. No other anaphylactic episodes have been reported. Steroid treatment could be definitively withdrawn after the second dose of Omalizumab, and all the other medications were later reduced. Twenty months after beginning, Omalizumab therapy is still ongoing with good symptomatology control; no side effects have been observed so far. Conclusions In our experience, Omalizumab is an effective treatment for children affected by Systemic Mastocytosis not responding to conventional medical treatments. The main strengths of this therapy are its rapid and extraordinary efficacy to control the severe mast cells mediator-related symptoms, the lack of side effects and its steroid-sparing effect. However, more extensive and controlled studies in pediatric patients affected by Systemic Mastocytosis are needed to substantiate these promising findings.

Abstract A 13-year-old Chinese girl attended to our Pediatric Dermatology Unit for the appearance of itchy targetoid lesions on the trunk, face and upper limbs. A skin biopsy showed histological findings typical of erythema multiforme minor. A month earlier she was admitted for the onset of a nephrotic syndrome and the renal biopsy showed an IgM nephropathy with a diffuse mesangial cell proliferation. There was no medical history of recent infections, fever, muscle or joint pain, drugs intake related to erythema multiforme and viral serology were negative. The role of antibodies in erythema multiforme could be more relevant than suspected and the severity of erythema multiforme was reported to be proportional to the antibody-mediated complement-dependent cytotoxicity, supporting the potential pathogenetic role for humoral immunity in this subtype of erythema multiforme. We reported the first association of erythema multiforme and IgM nephropathy in a pediatric patient providing an additional hint that an antibody-mediated process, rather than T-cell cytotoxicity, might represent the main pathogenetic mechanism in certain subtypes of erythema multiforme.

Key Clinical Message We present the case of a child developing widespread vesicle‐bullous lesions during an acute and symptomatic Epstein–Barr Virus infection. Antibody serology, biopsy, and direct immunofluorescence allowed the diagnosis of a paraviral bullous eruption. To our knowledge, this is the first report of bullous eruption following Epstein–Barr virus infection in childhood.

Preferentially Expressed Antigen in Melanoma (PRAME), a member of the cancer/testis antigen family, is central to the field of skin cancer diagnostics and therapeutics. As a nuclear receptor and transcriptional regulator, PRAME plays a critical role in inhibiting retinoic acid signalling, which is essential for cell differentiation and proliferation. Its aberrant overexpression in various malignancies, particularly cutaneous melanoma, is associated with more aggressive tumour phenotypes, positioning PRAME as both a diagnostic and prognostic marker. In melanoma, PRAME is typically highly expressed, in contrast to its weak or absent expression in benign nevi, thereby improving the accuracy of differential diagnoses. The diagnostic value of PRAME extends to various lesions. It is significantly expressed in uveal melanoma, correlating to an increased risk of metastasis. In acral melanomas, especially those with histopathological ambiguity, PRAME helps to improve diagnostic accuracy. However, its expression in spitzoid and ungual melanocytic lesions is inconsistent and requires a comprehensive approach for an accurate assessment. In soft tissue sarcomas, PRAME may be particularly helpful in differentiating melanoma from clear cell sarcoma, an important distinction due to their similar histological appearance but different treatment approaches and prognosis, or in detecting dedifferentiated and undifferentiated melanomas. In non-melanoma skin cancers such as basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma, the variable expression of PRAME can lead to diagnostic complexity. Despite these challenges, the potential of PRAME as a therapeutic target in melanoma is significant. Emerging immunotherapies, including T-cell-based therapies and vaccines targeting PRAME, are being investigated to exploit its cancer-specific expression. Ongoing research into the molecular role and mechanism of action of PRAME in skin cancer continues to open new avenues in both diagnostics and therapeutics, with the potential to transform the management of melanoma and related skin cancers.

Due to the increasing costs of livestock farming, it is important to find cost-effective alternatives of feed stuffs. This study investigated the effects of high-moisture ear corn (HMEC) feeding on the production performance, serum antioxidant capacity, immunity, and ruminal fermentation and microbiome of dairy cows. Thirty pluriparous Chinese Holstein cows were randomly allocated to two groups: steam-flaked corn (SFC) and HMEC (replacement of 2 kg equal dry matter SFC) and fed for a 60 day trial. The results showed replacing SFC with HMEC significantly increased dry matter intake, milk yield, and 4% fat-corrected milk yield (p < 0.05). Serum levels of superoxide dismutase, glutathione peroxidase, and immunoglobulins G, M, and A were significantly higher, and those of creatinine and cholesterol were significantly lower, in the HMEC group than in the SFC group (p < 0.05). HMEC also significantly increased total volatile fatty acid and acetate (p < 0.05) concentrations. In both groups, the dominant phyla of ruminal bacteria were Bacteroidetes, Firmicutes, and Actinobacteria, and the dominant genera were Prevotella, NK4A214-group, and Succiniclasticum. Mogibacterium, Eubacterium nodatum group, norank-f-Lachnospiraceae, and Eubacterium brachy group were significantly enriched in the ruminal fluid of HMEC-group cows (p < 0.05). In conclusion, replacing SFC with HMEC improved production performance, antioxidant capacity, and immunity, while regulating both ruminal fermentation and the composition of the ruminal microbiome in dairy cows.

Abstract Currently, there are a few detailed guidelines on the overall management of children and adolescents with moderate-severe atopic dermatitis. AD ​​is a complex disease presenting with different clinical phenotypes, which require an individualized and multidisciplinary approach. Therefore, appropriate interaction between primary care pediatricians, pediatric allergists, and pediatric dermatologists is crucial to finding the best management strategy. In this manuscript, members of the Italian Society of Pediatric Allergology and Immunology (SIAIP), the Italian Society of Pediatric Dermatology (SIDerP), and the Italian Society of Pediatrics (SIP) with expertise in the management of moderate-severe atopic dermatitis have reviewed the latest scientific evidence in the field. This narrative review aims to define a pathway to appropriately managing children and adolescents with moderate-severe atopic dermatitis.

Abstract is missing (Short communication)

Background: Pneumonia is one of the leading causes of death in children under 5 years of age. Although overall deaths from pneumonia have decreased substantially by 56%, since 1990 pneumonia contributes to about 740,000 deaths, per year. In Indonesia, in 2021, 444 children under five (CFR 0.16%) died due to pneumonia, in 2020, 498 children under five (CFR 0.16%), and in 2019, 551 children under five (CFR 0.12%). Increasing the scope of finding pneumonia in children under five is one of the efforts done in Indonesia to control pneumonia. The Influenza Like Illness and Severity Acute Respiratory System (ILI-SARI) surveillance is sentinel surveillance that is used to catch cases of pneumonia under five in outpatient and inpatient health facilities. Objective: This literature review aims to describe the implementation of ILI-SARI surveillance increasing the detection of pneumonia in children under five. Methods: The method used is to search the database through Google Scholar, Pubmed, and Research Gate. The key words used in this database search were ILI-SARI surveillance, Pneumonia under five. Results: There are 8 articles obtained and 5 articles analyzed through the suitability of the topic, objectives, methods used, sample size, and results from each article. Conclusion: Care-seeking activities are suggested to be an integral part of this method of preventing and controlling under-five pneumonia.

Summary: In mature bone, NGF is produced by osteoblasts following mechanical loading and signals through resident sensory nerves expressing its high affinity receptor, neurotrophic tyrosine kinase receptor type 1 (TrkA), to support bone formation. Here, we investigated whether osteoblastic expression of Toll-like receptor 4 (TLR4), a key receptor in the NF-κB signaling pathway, is required to initiate NGF-TrkA signaling required for load-induced bone formation. Although Tlr4 conditional knockout mice have normal skeletal mass and strength in adulthood, the loss of TLR4 signaling significantly reduced lamellar bone formation following loading. Inhibition of TLR4 signaling reduced Ngf expression in primary osteoblasts and RNA sequencing of bones from Tlr4 conditional knockout mice and wild-type littermates revealed dysregulated inflammatory signaling three days after osteogenic mechanical loading. In total, our study reveals an important role for osteoblastic TLR4 in the skeletal adaptation of bone to mechanical forces.

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A pasture-based swine management (PBSM) trial was conducted in Piemonte (N-W Italy) to study the performances and the carcass yield of 16 hybrid pigs (8 castrated males and 8 females; average initial weight: 90 kg). Animals were allowed to forage pea, clover, beet and alfalfa pastures for 170 days in a crop-pasture rotation on different paddocks. A concentrate was fed to supply 50% of estimated energy requirements. Forage dry matter intake (DMI) ranged from 0.32 kg/day (alfalfa) to 2.85 kg/day (pea), depending on the period and forage type. Pigs were weighted every 30 days and at slaughtering; average daily gain (ADG) was 0.29 kg. The stocking rate (SR) ranged from 109 kg/ha LW (clover) to 2347 kg/ha LW (pea). Data collected at slaughtering (average final weight: 141 kg) were: hot carcass weight and yield, lean and fat cuts weight, backfat thickness, pH45 and pH24. The statistical analysis (ANOVA of SPSS) did not show differences between males and females. Results showed that PBSM should be especially appealing to limited-resource farmers due to low inputs needed; pasture can be used to replace 50% of the nutritional needs, helping to save on grain costs, without affecting carcass characteristics.

The aim of the trial was to compare the average daily gain (ADG), the carcass characteristics, and the meat and fat quality of 18 Italian crossbred pigs fed high energy diets formulated for improved genotypes (digestible energy: DE >14 MJ/kg DM). Nine “Fumati” crossbreds (Large White x Mora Romagnola; average initial live weight: 84 kg) and nine “Borghigiana” (Large White x Nera di Parma; average initial live weight: 90 kg), reared under similar environmental and nutritional conditions, were slaughtered at the average final weight of 180 kg (285 days). Calculated dry matter intake (DMI) and feed conversion index (FCI) were similar; no significant differences were observed with respect to average daily gain (ADG: 679 vs. 658 g/d). At slaughtering, the dressing percentage of the Fumati was significantly lower than that of the Borghigiana (80.9 vs. 84.5). The Fumati seemed more prone to fattening than the Borghigiana, as confirmed by the statistically higher percentage of belly (14.9 vs.12.2), and fat (3.9 vs. 2.4) and marbling of M. longissimus dorsi (2.7 vs. 1.4). On colour analysis, the Fumati had statistically higher L* and hue values, and lower a* of M. longissimus dorsi. The fatty acid composition of meat was similar between crossbreds; backfat fatty acid composition of the Fumati showed a significantly higher percentage of saturated fatty acids (SFA), and lower amounts of monounsaturated and polyunsaturated fatty acids (MUFA and PUFA) than in the Borghigiana. Results showed that performances and meat quality of local crossbreeds still bred in semi-intensive systems, like Fumati and Borghigiana, can be positively influenced when fed diets considered suitable for improved pig genotypes.

Introduction: Neck and back pain afflicts millions of people. Magnetotherapy has shown to have anti-inflammatory effects that could act on pain generation, but the literature lacks provide a precise therapeutic protocol. Methods: A high-intensity electromagnetic field with a dedicated applicator was administered to 38 patients with low-back pain and 30 patients with neck pain. The device provides 60 mT and a frequency of 50 Hz for 30 minutes, the session was repeated 4 times. Results: The mean VAS of the low-back pain group decreased from 6.56 to 4.54, with a significant reduction of 30.8%. The mean VAS of the neck pain group decreased from 6.51 to 1.96, with a significant reduction of 69.9%. Discussion: The treatment used showed good results in both groups of the patient, without side effects. The therapeutic protocol adopted is safe, provide rapid relief from the pain and is not time demanding. This treatment could represent an effective non-pharmacologic physical therapy option in the treatment of low-back pain and cervical pain.

Patients with a stoma are at risk of developing peristomal skin complications (PSCs) that can negatively impact their quality of life. This study aims to identify potential risk factors for dermatitis, pruritis/xerosis, infections, and ulcerations among patients with a stoma and evaluate preventive measures. This cross-sectional study involved data regarding 232 Italian patients with a stoma. A questionnaire was used to collect patient characteristics, comorbidities, and stoma management data. The most frequent PSCs observed were dermatitis and pruritis/xerosis in approximately 60% of patients. Psoriasis was strongly correlated with dermatitis, while being overweight or obese increased the risk of pruritis/xerosis. Class 2 obesity and atopic dermatitis were associated with an increased risk of infections. Being underweight, completely nonautonomous, and having inflammatory bowel disease were associated with a higher risk of ulcerations, while radiotherapy was a strong risk factor for ulceration. Preventive measures such as using hydrocolloid barriers, TNT gauze cleansing, and low pH detergent were effective in preventing dermatitis. Appropriate stoma care and maintenance, including the use of protective film and careful monitoring of weight and comorbidities, are crucial in minimizing the risk of complications associated with a stoma.

Luca Stingeni,1 Anna Belloni Fortina,2 Ilaria Baiardini,3,4 Katharina Hansel,1 Devis Moretti,5 Filippo Cipriani5 1Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 2Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy; 3Respiratory Unit for Continuity of Care, IRCCS, Ospedale Policlinico San Martino, Genova, Italy; 4Personalized Medicine Asthma, & Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; 5Sanofi Genzyme, Sanofi S.r.l., Milan, ItalyCorrespondence: Anna Belloni FortinaUnit of Dermatology, Department of Medicine – DIMED, University of Padua, Via Gallucci, 4, Padova, 35128, ItalyEmail anna.bellonifortina@unipd.itBackground: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by recurrent eczematous lesions and intense pruritus. AD patients are known to face a considerable disease burden, including physical and emotional limitations. There is still limited knowledge about daily implications in education and occupation. We describe disease social stigmatization by measuring bullying and self-isolation in students and professional discrimination in workers. Overall loss of productivity, either at school and at the workplace, was quantified as the sum of absenteeism (number of days AD sick leave) and presenteeism (number of days with decreased focus and functionality).Methods: An on-line web survey was sent to 3235 random recipients and 401 met the inclusion criteria (self-reporting AD and ≥ 12 yo). The survey domains included daily limitations, QoL, feelings and relationships, together with specific questions about bullying, discrimination and loss of productivity.Results: AD negatively affected QoL in 51.6% of respondents, whereas 68.8% considered AD as a real limit to daily routine. More in detail, 39.3% of students were victims of bullying and 33.9% of workers felt discriminated because of AD. On average, absenteeism in students was for 17.1 days/year (presenteeism: 19.5 days/year), whereas in workers, the estimate was 10.9 days/year (presenteeism: 13.1 days/year). Absenteeism and presenteeism were more pronounced in bullied/discriminated subjects.Conclusion: AD multidimensional implications deeply affect and undermine personal and professional fulfillments. Our results contribute to a better understanding of what living with AD means.Keywords: atopic dermatitis, discrimination, absenteeism, presenteeism

Abstract. Objective:. Well-defined germ-line mutations in the PTCH1 gene are associated with syndromic multiple basal cell carcinomas (BCCs). Here, we used whole exome sequencing (WES) to identify the role of patched-1 in patients with multiple, unusually large BCCs. Methods:. A 72-year old patient presenting with numerous BCCs progressing to large ulcerating lesions was enrolled. WES was used to identify the pathogenic gene locus. Results:. Genetic work-up by WES identified a homozygous PTCH1 nonsense mutation in the tumor tissue but not present in her blood cells or in non-lesional skin. In addition, heterozygous missense mutations were identified in three cancer-associated genes (EPHB2, RET, and GALNT12) in blood cells as well as in lesional and non-lesional skin. We also tested systemic immune therapy as a potentially beneficial approach to treat patients with numerous large BCCs on scatted areas of involvement. A rapid and sustained response to nivolumab was noted, suggesting that it is an efficacious drug for long-term therapeutic outcome. Conclusion:. PTCH1, EPHB2, RET, and GALNT12 may potentially contribute to the synergistic oncogene driven malignant transformation manifesting as multiple, unusually large BCCs.

The Italian Consensus Conference on clinical management of atopic dermatitis in children reflects the best and most recent scientific evidence, with the aim to provide specialists with a useful tool for managing this common, but complex clinical condition. Thanks to the contribution of experts in the field and members of the Italian Society of Pediatric Allergology and Immunology (SIAIP) and the Italian Society of Pediatric Dermatology (SIDerP), this Consensus statement integrates the basic principles of the most recent guidelines for the management of atopic dermatitis to facilitate a practical approach to the disease. The therapeutical approach should be adapted to the clinical severity and requires a tailored strategy to ensure good compliance by children and their parents. In this Consensus, levels and models of intervention are also enriched by the Italian experience to facilitate a practical approach to the disease.