Background
Treatment of moderate‐to‐severe atopic dermatitis (AD) in the elderly may be challenging, due to side‐effects of traditional anti‐inflammatory drugs and to comorbidities often found in ...this age group. Furthermore, efficacy and safety of innovative drugs such as dupilumab are not yet well known.
Objectives
A multicentre retrospective, observational, real‐life study on the efficacy and safety of dupilumab was conducted in a group of patients aged ≥65 years and affected by severe AD. Their main clinical features were also examined.
Methods
Data of elderly patients with severe (EASI ≥24) AD treated with dupilumab at label dosage for 16 weeks were retrospectively collected. Treatment outcome was assessed by comparing objective (EASI) and subjective (P‐NRS, S‐NRS and DLQI) scores at baseline and after 16 weeks of treatment.
Results
Two hundred and seventy‐six patients were enrolled in the study. They represented 11.37% of all patients with severe AD. Flexural eczema was the most frequent clinical phenotype, followed by prurigo nodularis. The coexistence of more than one phenotype was found in 63/276 (22.82%) subjects. Data on the 16‐week treatment with dupilumab were available for 253 (91.67%) patients. Efficacy of dupilumab was demonstrated by a significant reduction of all the scores. No statistically significant difference regarding efficacy was found in elderly patients when compared to the group of our AD patients aged 18–64 years, treated with dupilumab over the same period. Furthermore, only 18 (6.52%) patients discontinued the drug due to inefficacy. Sixty‐one (22.51%) patients reported adverse events, conjunctivitis and flushing being the most frequent. One (0.36%) patient only discontinued dupilumab due to an adverse event.
Conclusions
Therapy with dupilumab led to a significant improvement of AD over a 16‐week treatment period, with a good safety profile. Therefore, dupilumab could be considered as an efficacious and safe treatment for AD also in the elderly.
Central Obesity in Children with Psoriasis Guidolin, Lucia; Borin, Marco; Fontana, Elena ...
Acta dermato-venereologica,
2018-Feb-07, Letnik:
98, Številka:
2
Journal Article
The efficacy and safety of acitretin was evaluated retrospectively in a cohort of 46 patients with moderate to severe plaque psoriasis (Psoriasis Area and Severity Index (PASI) range 10-42). Patients ...were treated at an initial dose of 10 mg/day acitretin, which was then gradually increased until the best therapeutic effect with the fewest adverse effects was reached (< 50 mg/day) and later decreased and maintained at the lowest effective dosage. Efficacy measures were: (i) PASI75 (75% improvement) and PASI50 between 10 and 16 weeks; and (ii) PASI75 even after 16 weeks of treatment. At weeks 10-16, PASI75 and PASI50 were achieved by 47.8% and 87% of the patients, respectively. Overall, 67.3% reached PASI75. Adverse events occurred in 18 patients (39.1%); among these, 4 (8.7%) discontinued acitretin. Our findings suggest that acitretin at an initial low, gradually escalating dose, and subsequently maintained at the minimal effective dose, is a suitable treatment option for plaque psoriasis as it provides clear-cut improvement in most treated patients while minimizing the risks of side-effects.
Gartner's duct cyst: report of three cases Paradies, G; Zullino, F; Caroppo, F ...
La Pediatria medica e chirurgica,
2011 Sep-Dec, Letnik:
33, Številka:
5-6
Journal Article
Recenzirano
Gartner's duct cyst is a rare condition consequent to an unfinished disappearance of the mesonephric duct in females. In this report we present three cases of mesonephric duct remnants cysts: two of ...these were originated from its proximal part ,paraooforon, whereas in the third case the cyst was originated from its paraurethral distal end. These lesions are an uncommon and extremely rare manifestations in paediatric age and more in neonatal age: therefore we believe very interesting and useful to report these cases, describe their clinical data, debate the embryogenic origins, discuss diagnostic and therapeutic problems according to international literature.
Phytoplankton size is a significant functional trait affecting many ecological processes and influencing the carbon fate and the trophic regimes of the ecosystems. In this study, we examined the ...effect of the lateral advection of nutrient-rich Messina Mixed Waters on the phytoplankton size structure and community composition in the euphotic layer of the Gulf of Augusta (Western Ionian Sea) in early autumn. The chlorophyll a concentration ranged from 0.08 to 0.8 mg m−3 and the phytoplankton abundances ranged from 21 × 103 to 245 × 103 cells L−1. The size structure of phytoplankton biomass, obtained by sequential filtration of water samples, suggested the dominance of micro-planktonic diatoms in an active Deep Chlorophyll Maximum (DCM) whereas smaller forms were mainly represented by phytoflagellates. A short-term tidal-induced variability of the assemblage structure was observed at a “sentinel” station located at the Gulf shelf-break where lateral advection due to meso-scale dynamics sustained most of the phytoplankton biomass.
Our research shows that, in stratified conditions, nutrient enrichment by lateral advection at DCM modifies the size-structure of phytoplankton with respect to that expected from the reference baseline oceanic model validated in open ocean waters. In particular, while smaller fraction incidences reveal a surface oligotrophic system, an increase of the micro-sized fraction is triggered at DCM: this indicates the prevalence of “new production” processes which is a quite unusual condition for the Mediterranean DCM in early autumn, when trophic web is typically sustained by “regenerate production”. Our observations suggest that both “microbial” and “herbivore” pathways could coexist and regulate the carbon flow in the Gulf in this season.
•Lateral advection of nutrient-rich waters shaped local phytoplankton size-structure.•Micro-phytoplankton fraction incidence overcomes the reference baseline oceanic model.•A micro-sized diatoms core pool dominated spatial and time-series coastal assemblages.•Meso-scale dynamics influenced phytoplankton composition and relative size incidences.
Fourier Transform Infrared Spectroscopy has been employed to investigate the composition of the shells of two marine bivalves Mytilus galloprovincialis and Corbula gibba from four samples collected ...from the Mar Piccolo of Taranto (Ionian Sea, Southern Italy). Bivalve shells are composed of 95–99.9% calcium carbonate (CaCO3), while the remaining portion is constituted by organic matrix, which in some cases may incorporate pollutants from the surrounding environment. Recognizing the role of bivalves in the carbon biogeochemical cycle and their economic importance for aquaculture, we aimed to develop a methodology for shells powder samples preparation and analysis. The main objective of the study was to demonstrate the feasibility of Fourier Transform Infrared photoacoustic spectroscopy to perform a fast sample analysis in order to detect the possible presence of pollutants in the shells.
The results revealed an unbiased differentiation between the shell compositions of the two bivalve selected species. Moreover, the spectra interpretation indicated that C. gibba specimens recorded a shell matrix contaminated by organic pollutants present in the surrounding environment. In conclusion, the described methodology including sample preparation tailored for photoacoustical investigations demonstrated to be a tool for the characterization of bivalve shells contamination enhancing environmental studies of polluted marine areas.•Bivalve species were collected from sampling stations located in the Mar Piccolo of Taranto (Ionian Sea, Southern Italy).•Samples preparation stages include: sonication, grinding and fractioning by sieving.•FT-IR PAS spectral region of interest is in the mid-infrared between 4000 and 400 cm−1.
Display omitted
Systemic mastocytosis (SM) is frequently associated with eosinophilia. To examine its prevalence and clinical impact in all WHO classification-based subcategories, we analyzed eosinophil counts in ...2350 mastocytosis patients using the dataset of the European Competence Network on Mastocytosis. Ninety percent of patients had normal eosinophil counts, 6.8% mild eosinophilia (0.5-1.5 × 10
/l), and 3.1% hypereosinophilia (HE; >1.5 × 10
/l). Eosinophilia/HE were mainly present in patients with advanced SM (17%/19%), and only rarely recorded in patients with indolent and smoldering SM (5%/1%), and some patients with cutaneous mastocytosis. The eosinophil count correlated with organomegaly, dysmyelopoiesis, and the WHO classification, but not with mediator-related symptoms or allergy. Eosinophilia at diagnosis had a strong prognostic impact (p < 0.0001) on overall survival (OS) and progression-free survival (PFS), with a 10-year OS of 19% for patients with HE, 70% for those with mild eosinophilia, and 88% for patients with normal eosinophil counts. In 89% of patients with follow-up data (n = 1430, censored at start of cytoreductive therapy), eosinophils remained stable. In those with changing eosinophil counts (increase/decrease or mixed pattern), OS and PFS were inferior compared with patients with stable eosinophil counts. In conclusion, eosinophilia and HE are more prevalent in advanced SM and are predictors of a worse outcome.
PDF
