1,721,007 research outputs found
Unità di Crescita nei sistemi di Conoide Alluvionale del tardo Quaternario: La risposta dei corsi d'acqua ai cicli climatici ed ai movimenti tettonici.
No full textAnti-leukotrienes in the treatment of allergic conjunctivities and comorbidities in children: an update
No full textThe term “Allergy” actually includes a variety of different diseases (rhinitis, conjunctivitis, asthma, urticaria, and dermatitis) with a common pathological basis linked to the release of chemical mediators such as histamine, platelet-activating factor, arachidonic acid metabolites, and chemotactic factors secreted by mastocytes, basophils, and eosinophils. The key-role of leukotrienes (LTs) as mediators in allergic and inflammatory response justifies possible therapeutic use of leukotriene antago-nists in other allergic diseases beyond asthma. LTs modifiers reduce asthma symptoms, short-acting beta2-antagonist (SABA) use, and asthma exacerbations, and improve all indexes of pulmonary function, as measured by the increases in forced expiratory flow at one second (FEV1), peak expiratory flow (PEF), quality of life, and indices of bronchial inflammation (blood eosino-phils, inflammatory cells in the bronchial mucosa, exhaled nitric oxide, substance P, neurokinin A, eosinophil cationic protein, and serum myeloperoxidase). Anti-LTs have also been successfully used by some authors to control allergic diseases such as rhinitis, atopic dermatitis, chronic urticaria and allergic conjuncitivitis. Moreover, recently, new reports have been published concerning other conditions (migraine prophylaxis, sleep disorders, inflammatory bowel disease, and nasal polyposis) that broaden the future range of clinical applications. Topical ocular montelukast can be a potential therapeutic drug with a new route of administration that can be used for treatment of allergic conjunctivitis
Emerging pathogens in cystic fibrosis: Ten years of follow-up in a cohort of patients
No full textIn patients with cystic fibrosis (CF), there is an increasing incidence of some uncommon respiratory pathogens, such as Burkholderia cepacia complex (Bcc), Stenotrophomonas maltophilia, and Achromobacter xylosoxidans. In order to evaluate the prevalence and the clinical impact of these pathogens, we retrospectively studied a total of 109 patients followed in our center from 1996 to 2006 and reviewed the results of 1,550 sputum samples. The isolation of Pseudomonas aeruginosa slightly decreased over the observed decade, whereas Staphylococcus aureus exhibited an irregular trend. Infection with Bcc reached a peak in 1998 and successively decreased to a stable 4%. S. maltophilia and A. xylosoxidans were the real emerging pathogens, since first isolation occurred in 2004; however, the percentage of infected patients remained low (7% and 3.2%, respectively) through the years. In conclusion, in our center for CF, the reduced prevalence of P. aeruginosa over the last decade has been associated with a concurrent reduction of infections by Bcc and, as compared to other centers in Italy, Europe, and the US, with a low incidence of emerging pathogens such as S. maltophilia and A. xylosoxidans
ANALISI ECONOMICA RETROSPETTIVA SULLE MISURE DI CONTENIMENTO DELLA SPESA FARMACEUTICA DELL’ASP 1 DI AGRIGENTO RELATIVE AL TRIENNIO 2010/2011/2012
Full text linkIntroduzione. Le misure di contenimento della spesa
farmaceutica sono state le principali prerogative previste dal
Piano di Rientro della Regione Sicilia ( adempimento A.1.2),
in tal senso le realtà delle singole ASP si sono adeguate alle
direttive regionali mostrando una classifica tra le Asp
siciliane che vedono come protagonista virtuosa l’Asp di
Agrigento, prima in classifica. La disamina dei dati fa
riferimento al triennio 2010/2011/2012.
Materiali e metodi. La rilevazione concerne farmaci
rimborsati dal SSN ed erogati tramite canale convenzionale
privato, farmaci distribuiti direttamente e quelli utilizzati in
ambito ospedaliero nel triennio 2010/2011/2012, attraverso
report sulla spesa farmaceutica della regione Sicilia.
Risultati. Nel 2010 la spesa farmaceutica annua è stata per
l’ASP 1 di Agrigento di € 102.942.864,99, questa grazie
all’incremento della distribuzione diretta, di cui al PHT
D.A.2205/08 attraverso l’introduzione di molecole
appartenenti alla categoria N05A (l’11,03 % della spesa
totale nell’anno 2011) secondi solo agli antianemici categoria
B03X (26,93 % della spesa totale) già presenti nel 2010. La
spesa della distribuzione diretta nel 2011 è stata di €
13.973.336,60 mentre la distribuzione attraverso le farmacie
private avrebbe fatto lievitare la spesa totale a €
25.006.073,81 nel 2012 invece l’importo è stato di €
14.953.719,04 ed attraverso il canale privato convenzionato
avremmo avuto un costo di € 29.530.504,13 . La spesa totale
dell’Asp è passata dunque da € 102.942.864,99 nel 2010, a €
92.883.552,99 nel 2011, a € 91.128.889,13 nel 2012.
Conclusioni. Le misure adottate per il contenimento della
spesa hanno previsto l’introduzione a partire dal 2011 degli
antipsicotici atipici, ed il potenziamento del primo ciclo di
terapia per il periodo susseguente alla dimissione ospedaliera
in base ai criteri dettati dal D.A. 0150/08 portando l’ASP di
Ag ad essere tra le più virtuose della regione Sicilia passando
dunque dalla sesta posizione in classifica nel 2010 alla prima
nel 2012 con un risparmio pari al 11,48 %, il passaggio degli
antipsicotici è stato dettato anche dalla necessità dei pazienti
che hanno nell’essere sottoposti a controlli periodici da parte
degli specialisti ma anche alla valutazione
dell’appropriatezza prescrittiva che in quest’ultimo caso è
affidato al farmacista ospedaliero. Un altro obiettivo
dell’ASP 1 di Agrigento mirato ad un ulteriore contenimento
della spesa è quello di estendere la distribuzione diretta anche
alla prescrizione successiva ad ogni visita specialistica ambulatoriale
Polyuria and polydipsia in a 5 year-old child: diagnostic problems
No full textPolyuria and polydipsia could be present in three groups of diseases; polydipsia psicogena characterized by an excessive water intake, central diabetes insipidus (CDI) with a defect in the production of AVP and nephrogenic diabetes insipidus in which a defect in the renal response to vasopressin is present. In particular, CDI can be caused by lesions like germinoma and craniopharyngioma, Langerhans'cell histiocytosis, inflammatory, autoimmune and vascular diseases, trauma resulting from surgery or an accident; and in rare cases, genetic defects in the synthesis of vasopressin that are inherited as autosomal dominant or X-linked recessive traits. However, 30% to 50% of cases are considered idiopathic. Nevertheless, 30-50% of cases is considered idiopathic. Here we present the case of a 5.5 year-old female patient, referred to our Department of Endocrinology Surgery for polyuria and polydipsia. Hormonal tests demonstrated the presence of CDI with normal anterior pituitary function. Magnetic resonance imaging showed the lack of hyperintensity of posterior pituitary. Pituitary stalk was median and of regular volume. Diagnosis of CDI has been confirmed and therapy has been started with desmopressin (Minirin) 0.2 mg/die. During the follow-up the patient was in good conditions, presented an adequate hydro-electrolytic balance and normal growth velocity. Anterior pituitary function was normal and MR remained stable. This case report highlights problems concerning differential diagnosis and the importance of a careful follow-up which must involve the whole family
Hepatitis B vaccine in celiac disease: Yesterday, today and tomorrow
No full textSome studies showed that in celiac patients the immunological response to vaccination is similar to that one found in general population except for vaccine against hepatitis B virus (HBV). The non-responsiveness to HBV vaccine has also been described in healthy people, nevertheless the number of non-responders has been demonstrated to be higher in celiac disease (CD) patients than in healthy controls. Several hypothesis explaining this higher rate of unresponsiveness to HBV vaccine in CD patients have been described, such as the genetic hypothesis, according with CD patients carrying the disease-specific haplotype HLA-B8, DR3, and DQ2, show a lower response to HBV vaccine both in clinical expressed CD patients and in healthy people carrying the same haplotype. On the other hand, it has been demonstrated that the gluten intake during the vaccination seems to influence the response to the same vaccine. Moreover, it has been demonstrated a possible genetic predisposition to hepatitis B vaccine non-responsiveness likely due to the presence of specific human leukocyte antigen haplotypes and specific single nucleotide polymorphism in genes of cytokine/cytokine receptors and toll like receptors, but the pathogenic mechanism responsible for this low responsiveness still remains unclear. The aim of this review is to focus on the possible pathogenic causes of unresponsiveness to HBV vaccine in CD patients and to propose an alternative vaccination schedule in order to improve the responsiveness to HBV vaccine in this at-risk patients
Multi-temporal Analysis of the Urban Heat Island (UHI) Effect Using Satellite Imagery in the Phlegrean Area
No full textAbstract
Urbanization and the concurrent loss of green areas determine changes in land surface temperature (LST) and worsen the phenomenon of urban heath islands (UHI). To understand these relationships, long-term studies have been carried out using remote sensing data, analyzing the trend over a large area. This study is aimed at multi-temporal analysis based on satellite data for calculating LST and land use indices to identify their interaction with UHIs during the period 2000–2023, in the region known as Phlegrean Area, in Campania (Italy). Results reveal that the reference period was characterized by increasing LST which affected UHI share and intensity. On the other hand, we observed a contraction of greenery in favor of urban areas. Furthermore, in the same period of observation, it is noteworthy the loss of more than 3 km2 of forests due to a severe wildfire. In conclusion, the model results show that there could be a correlation between the increase in artificial surfaces and the increase in temperatures and consequently the enlargement of UHI areas. A greater attention in the design of green areas in urban contexts, considering sustainability and ecology targets, could help mitigating UHI phenomenon
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