How to fight SARS-COV-2 vaccine hesitancy in patients suffering from chronic and immune-mediated skin disease: four general rules.

All public health ministries have implemented strategies to contain the spread of COVID-19 worldwide. Vaccines against SARS-CoV-2 still represent the most effective weapon to combat the circulation of the virus, in order to decrease the impact of COVID-19 on the general health of the population, to prevent the emergence of new SARS-CoV-2 variants and avoid excessive hospitalization. However, the success of a vaccination campaign largely depends on the penetrance of the message addressed to general population, which takes on an even more strategic value when vaccine candidates suffer from chronic diseases. In this view, patients suffering from immune-mediated skin diseases could represent a "weak link in the vaccine chain." Our main objective is to focus attention on four main elements in support of vaccination strategy in order to promote the patients' awareness to be at highest risk of negative consequences in case of SARS-Cov-2 infection, and to build, strengthen and maintain trust in vaccines' efficacy and safety.

Certolizumab for the treatment of psoriasis and psoriatic arthritis: a real-world multicentre Italian study.

BACKGROUND: Certolizumab, a pegylated tumour necrosis factor-α inhibitor, reduced disease activity in randomized trials of patients with psoriasis and psoriatic arthritis. Real-life data are missing. OBJECTIVE: To confirm the effectiveness and safety of certolizumab in patients with psoriasis and psoriatic arthritis in routine clinical practice. METHODS: In this retrospective study involving 11 Italian sites, patients with psoriasis and psoriatic arthritis received subcutaneous certolizumab (400 mg loading dose at 0, 2 and 4 weeks, followed by 200 mg every 2 weeks) for up to 52 weeks. Primary outcomes included mean change from baseline in Psoriasis Area and Severity Index (PASI) and modified Nail Psoriasis Severity Index (mNAPSI) scores, and the proportion of patients achieving a 75%, 90% or 100% reduction in PASI score. Other endpoints included Disease Activity Score computed on 44 joints correlated with the erythrocyte sedimentation rate during the first hour (DAS44-ESR), Tender Joint Count (TJC), Swollen Joint Count (SJC), pain [visual analogue scale (VAS) score], inflammatory markers and quality of life (QOL). RESULTS: In the study were enrolled 153 patients (mean age: 55 years). Certolizumab reduced the mean PASI score from baseline by 4.45, 6.30 and 7.58 at weeks 12, 24 and 52, respectively (P < 0.001 for all). At weeks 24 and 52, 69.6% and 83.3% of patients had a PASI score ≤3. DAS44-ESR, TJC, SJC and mNAPSI scores, and pain VAS were also all significantly improved from baseline at each time point. C-reactive protein levels decreased during treatment, being significant at week 24. On multivariate analysis, psoriasis duration, baseline PASI, mNAPSI and pain VAS scores were found to be predictive of the improvement in PASI score at week 12. CONCLUSION: Certolizumab displayed also in the real-life encouraging results in both psoriasis and psoriatic arthritis patients.

Neuromarketing empirical approaches and food choice: A systematic review.

Consumers' food choices are often driven by reasons of which consumers are not fully aware. Decision-making about food is influenced by a complex set of emotions, feelings, attitudes, and values that are impossible to assess simply by asking consumers their opinions. Indeed, traditional techniques, such as self-reports or interviews, mainly allow the measurement of conscious and rational reactions to a product or advertising. Recently, there has been a rapidly growing interest in the multidisciplinary field of "neuromarketing," which takes advantage of neuroscientific techniques to study consumer behavior. This discipline applies neuroscientific methods and tools that allow the measurement of consumers' emotional and spontaneous reactions in a more objective and observable way. The aim of this paper is (a) to describe neuromarketing's underlying assumptions, techniques, and the advantages of this perspective, examining the scientific literature on the use of neuromarketing in food studies; and (b) to suggest best practices to apply this novel approach in the food marketing domain, with a specific focus on non-invasive methods. Finally, although the perception of nutritional elements has already been explored, the health content of labels, the presence of additives, and the evaluation of the information conveyed by food packaging remain other possible elements of interest in future food neuromarketing research.

Ingenol mebutate in actinic keratosis: a clinical, videodermoscopic and immunohistochemical study.

BACKGROUND: Actinic keratosis (AK) is a cutaneous intraepithelial neoplasm that typically develops on sun-damaged skin. The incidence of AK is increasing worldwide, and it is accepted as the most frequent pre-malignant lesion in humans. OBJECTIVES: To demonstrate that ingenol mebutate gel is effective in the treatment of actinic keratoses because of its clinical, dermoscopic, capillaroscopic, histopathological and immunohistochemical treatment outcomes. METHODS: Sixty individuals with multiple non-hypertrophic AKs were enrolled into this non-randomized, open-label, prospective, trial. Acquisition of clinical, dermoscopic and capillaroscopic images at baseline (T0), immediately after treatment on 3rd (trunk and/or extremities) or 4th (scalp and/or face) day (T1), 14 days after the end of the treatment (T2) and at 60 days (T3). A subgroup of 20 patients received a cutaneous biopsy both at baseline and at T3 for histological and immunohistochemical evaluation. RESULTS: Clinical improvement was observed in 100% of cases: total clearance in 41 patients (68.3%); partial clearance in 19 patients (32.7%). After treatment, dermoscopic improvement of all non-pigmented and pigmented AK lesions was observed. Most of the dermoscopic features disappeared with treatment. Total disappearance of specific vascular structures or significant reduction in the number and calibre of new blood vessels was capillaroscopically observed in all patients analysed (P ≤ 0.001). The immunohistochemical expression of p63 (P = 0.002), Ki-67 (P = 0.015) and VEGF (P = 0.016) significantly decreased. CONCLUSIONS: The clinical efficacy of ingenol mebutate on AKs is confirmed by its effect on angiogenesis, stem cell activity and cell proliferation in vivo.

Granuloma faciale successfully treated with ingenol mebutate.

Granuloma faciale (GF) is a rare chronic inflammatory dermatosis of unknown etiology, characterized by leukocitoclastic vasculitis usually occurring on the face. We report a case of 60-years-old man with 3 year history of multiple actinic keratoses (AK) and persistent asymptomatic erythematous papules and plaques located over his left temporal region and the cheek: histopathology was consistent with GF. Herein we describe the successful treatment of the lesion with ingenol mebutate 0.015% gel focusing on the clinical, dermoscopic and histopathological findings of GF both before and after treatment.

On the robustness of the geometrical model for cell wall deposition.

All plant cells are provided with the necessary rigidity to withstand the turgor by an exterior cell wall. This wall is composed of long crystalline cellulose microfibrils embedded in a matrix of other polysaccharides. The cellulose microfibrils are deposited by mobile membrane bound protein complexes in remarkably ordered lamellar textures. The mechanism by which these ordered textures arise, however, is still under debate. The geometrical model for cell wall deposition proposed by Emons and Mulder (Proc. Natl. Acad. Sci. 95, 7215-7219, 1998) provides a detailed approach to the case of cell wall deposition in non-growing cells, where there is no evidence for the direct influence of other cellular components such as microtubules. The model successfully reproduces even the so-called helicoidal wall; the most intricate texture observed. However, a number of simplifying assumptions were made in the original calculations. The present work addresses the issue of the robustness of the model to relaxation of these assumptions, by considering whether the helicoidal solutions survive when three aspects of the model are varied. These are: (i) the shape of the insertion domain, (ii) the distribution of lifetimes of individual CSCs, and (iii) fluctuations and overcrowding. Although details of the solutions do change, we find that in all cases the overall character of the helicoidal solutions is preserved.

Capillary filling in microchannels with wall corrugations: a comparative study of the Concus-Finn criterion by continuum, kinetic, and atomistic approaches.

We study the impact of wall corrugations in microchannels on the process of capillary filling by means of three broadly used methods: computational fluid dynamics (CFD), lattice Boltzmann equations (LBE), and molecular dynamics (MD). The numerical results of these approaches are compared and tested against the Concus-Finn (CF) criterion, which predicts pinning of the contact line at rectangular ridges perpendicular to flow for contact angles of theta > 45 degrees . Whereas for theta = 30, 40 (no flow), and 60 degrees (flow) all methods are found to produce data consistent with the CF criterion, at theta = 50 degrees the numerical experiments provide different results. Whereas the pinning of the liquid front is observed both in the LB and CFD simulations, MD simulations show that molecular fluctuations allow front propagation even above the critical value predicted by the deterministic CF criterion, thereby introducing a sensitivity to the obstacle height.

Front pinning in capillary filling of chemically coated channels.

The dynamics of capillary filling in the presence of chemically coated heterogeneous boundaries is investigated both theoretically and numerically. In particular, by mapping the equations of front motion onto the dynamics of a dissipative driven oscillator, an analytical criterion for front pinning is derived under the condition of diluteness of the coating spots. The criterion is tested against two-dimensional lattice Boltzmann simulations and found to provide satisfactory agreement as long as the width of the front interface remains much thinner than the typical heterogeneity scale of the chemical coating.

[Laser conization for cervical intraepithelial neoplasias, grade III. Personal experience of 77 cases]. / Laser conizzazione nelle neoplasie intraepiteliali della cervice di III grado. Nostra esperienza su 77 casi.

BACKGROUND: Evalutation of the efficacy of laser conization for cervical high-grade squamous intraepithelial lesions (Hg-SIL). METHODS: A retrospective evaluation. Case collection: A total of 77 women, 47 outpatients and 30 inpatients with endocervical CIN3 or CIN2, were treated by carbon dioxide (CO2) laser between 1993 and 1995. A preoperative diagnosis has been made by means of Pap-smear, colposcopy and marked biopsy. In 47 cases a laser conization was performed in Day Surgery, without vessel constrictors or local anesthetics. In 30 cases a narcosis (Diprivan ) was induced. The former were discharged 2-3 hours and the latter 24 hours after treatment. RESULTS: The histological examination confirmed preoperative diagnosis in 64 (86.5%) cases and negligible one grade discrepancy was reported in 7 cases (6 over- and 1 underestimated); missed invasion and no free margins were reported in the remaining 4 and 2 patients respectively, so these latter 6 patients were submitted to other surgical procedures. No serious complications occurred with the exception of mild vaginal postoperative bleeding. During the follow-up of 36-82 months, cervical alterations were described only in 12 out of 71 cases, flat condilomatosy in 8 cases, CIN2 in 2 patients and CIN3 in other 2 patients. At present, all the patients are free of disease. CONCLUSIONS: The conization with dioxide laser is a good therapy for cervical intraepithelial neoplasia, even if expensive; infact poor side-effects are observed as well as a very good reliability.

[The role of some micronutrients in the evolution of HPV infection]. / Ruolo di alcuni micronutrienti (Vit. A, Vit. E, GSH-Px) nell'evoluzione dell'infezione da HPV.

BACKGROUND: Over the past few years a series of research projects has shown that the scant or deficient immune response in HIV infection may be secondary to reduced cell resistance and/or the uncontrolled formation of free radicals. In line with these findings, subjects with HIV infection present a deficit of polyunsaturated fatty acids (the principal components of cell membranes) and many antioxidating substances, like Vitamin E and glutathione peroxidase. The high incidence of heterosexual transmission of HIV has now shown the close correlation between HIV infection and HPV infection. By analogy, we wanted to ascertain whether these deficits were also present in subjects with HPV infection and dysplastic and neoplastic lesions of the uterine cervix. Published data confirm that a HPV-positive subject has an increased risk, ranging from 40 to 200%, of contracting HIV infection. METHODS: Eighty women with HPV infection of the genital tract, at various stages. Blood levels of vitamin E and polyunsaturated fatty acids were measured using gas-chromatography; glutathione was assayed using the spectrophotometric technique. RESULTS: The alternation of the aforesaid parameters is correlated to the progress of infection and increases with the severity of lesions; Statistically significant data were recorded by comparing the group with condylomatosis with patients diagnosed with cervical carcinoma (p<0.001). CONCLUSIONS: The increased possibility that some patients are affected by an association of HPV and HIV depends on the anomalous or scarce function of many immunocompetent cells, as well the quantitative immune deficiency induced by the initial virus and the presence of various mechanisms that facilitate the development of the infection.

Leiomyosarcomas of the small intestine misdiagnosed as ovarian masses: report of three cases.

Leiomyosarcomas of the small intestine are rare lesions. Because of their aspecific symptoms, diagnosis is often made at a late stage and, in women, must be distinguished from ovarian tumors. Three cases of large, abdominal masses, evaluated preoperatively as being ovarian tumors, are presented. At histology all three were diagnosed as leiomyosarcomas of the small intestine.