Efficacy and safety of antiparasitic therapy for neurocysticercosis in rural Tanzania: a prospective cohort study.

PURPOSE: Neurocysticercosis is common in regions endemic for Taenia solium. Active-stage neurocysticercosis can be treated with antiparasitic medication, but so far no study on efficacy and safety has been conducted in Africa. METHODS: We conducted a prospective cohort study on treatment of neurocysticercosis in Tanzania between August 2018 and January 2022. Patients were initially treated with albendazole (15 mg/kg/d) for 10 days and followed up for 6 months. Additionally in July 2021, all participants who then still had cysts were offered a combination therapy consisting of albendazole (15 mg/kg/d) and praziquantel (50 mg/kg/d). Antiparasitic treatment was accompanied by corticosteroid medication and anti-seizure medication if the patient had experienced epileptic seizures before treatment. RESULTS: Sixty-three patients were recruited for this study, of whom 17 had a complete follow-up after albendazole monotherapy. These patients had a total of 138 cysts at baseline, of which 58 (42%) had disappeared or calcified by the end of follow-up. The median cyst reduction was 40% (interquartile range 11-63%). Frequency of epileptic seizures reduced considerably (p < 0.001). Three patients had all active cysts resolved or calcified and of the remaining 14, eight received the combination therapy which resolved 63 of 66 cysts (95%). Adverse events were infrequent and mild to moderate during both treatment cycles. CONCLUSION: Cyst resolution was unsatisfactory with albendazole monotherapy but was very high when it was followed by a combination of albendazole and praziquantel.

Energetics, but not development, is impacted in coral embryos exposed to ocean acidification.

In light of the chronic stress and mass mortality reef-building corals face under climate change, it is critical to understand the processes driving reef persistence and replenishment, including coral reproduction and development. Here, we quantified gene expression and sensitivity to ocean acidification across a set of developmental stages in the rice coral, Montipora capitata. Embryos and swimming larvae were exposed to pH treatments of 7.8 (ambient), 7.6 (low) and 7.3 (extreme low) from fertilization to 9 days post-fertilization. Embryo and larval volume, and stage-specific gene expression were compared between treatments to determine the effects of acidified seawater on early development. Although there was no measurable size differentiation between pH treatments at the fertilized egg and prawn chip (9 h post-fertilization) stages, early gastrulae and larvae raised in reduced pH treatments were significantly smaller than those raised in ambient seawater, suggesting an energetic cost to developing under low pH. However, no differentially expressed genes were found until the swimming larval stage. Notably, gene expression patterns of larvae developing at pH 7.8 and pH 7.3 were more similar than those of larvae developing at pH 7.6. Larvae from pH 7.6 showed upregulation of genes involved in cell division, regulation of transcription, lipid metabolism and response to oxidative stress in comparison to the other two treatments. Although low pH appears to increase energetic demands and trigger oxidative stress in larvae, the developmental process is robust to this at a molecular level, with the swimming larval stage reached in all pH treatments.

Genetic resistance determinants to fusidic acid and chlorhexidine in variably susceptible staphylococci from dogs.

BACKGROUND: Concern exists that frequent use of topically-applied fusidic acid (FA) and chlorhexidine (CHX) for canine pyoderma is driving clinically relevant resistance, despite rare description of FA and CHX genetic resistance determinants in canine-derived staphylococci. This study aimed to determine minimum inhibitory concentrations (MICs) and investigate presence of putative resistance determinants for FA and CHX in canine-derived methicillin-resistant (MR) and -susceptible (MS) staphylococci. Plasmid-mediated resistance genes (fusB, fusC, fusD, qacA/B, smr; PCR) and MICs (agar dilution) of FA and CHX were investigated in 578 staphylococci (50 MR S. aureus [SA], 50 MSSA, 259 MR S. pseudintermedius [SP], 219 MSSP) from Finland, U.S.A., North (NUK) and South-East U.K. (SEUK) and Germany. In all isolates with FA MIC ≥64 mg/L (n = 27) fusA and fusE were amplified and sequenced. RESULTS: FA resistance determinants (fusA mutations n = 24, fusB n = 2, fusC n = 36) were found in isolates from all countries bar U.S.A. and correlated with higher MICs (≥1 mg/L), although 4 SP isolates had MICs of 0.06 mg/L despite carrying fusC. CHX MICs did not correlate with qacA/B (n = 2) and smr (n = 5), which were found in SEUK SA, and SP from NUK and U.S.A. CONCLUSIONS: Increased FA MICs were frequently associated with fusA mutations and fusC, and this is the first account of fusB in SP. Despite novel description of qacA/B in SP, gene presence did not correlate with CHX MIC. Selection pressure from clinical use might increase prevalence of these genetic determinants, but clinical significance remains uncertain in relation to high skin concentrations achieved by topical therapy.

Dimerization leads to changes in APP (amyloid precursor protein) trafficking mediated by LRP1 and SorLA.

Proteolytic cleavage of the amyloid precursor protein (APP) by α-, ß- and γ-secretases is a determining factor in Alzheimer's disease (AD). Imbalances in the activity of all three enzymes can result in alterations towards pathogenic Aß production. Proteolysis of APP is strongly linked to its subcellular localization as the secretases involved are distributed in different cellular compartments. APP has been shown to dimerize in cis-orientation, affecting Aß production. This might be explained by different substrate properties defined by the APP oligomerization state or alternatively by altered APP monomer/dimer localization. We investigated the latter hypothesis using two different APP dimerization systems in HeLa cells. Dimerization caused a decreased localization of APP to the Golgi and at the plasma membrane, whereas the levels in the ER and in endosomes were increased. Furthermore, we observed via live cell imaging and biochemical analyses that APP dimerization affects its interaction with LRP1 and SorLA, suggesting that APP dimerization modulates its interplay with sorting molecules and in turn its localization and processing. Thus, pharmacological approaches targeting APP oligomerization properties might open novel strategies for treatment of AD.

Algorithmic structural segmentation of defective particle systems: a lithium-ion battery study.

We describe a segmentation algorithm that is able to identify defects (cracks, holes and breakages) in particle systems. This information is used to segment image data into individual particles, where each particle and its defects are identified accordingly. We apply the method to particle systems that appear in Li-ion battery electrodes. First, the algorithm is validated using simulated data from a stochastic 3D microstructure model, where we have full information about defects. This allows us to quantify the accuracy of the segmentation result. Then we show that the algorithm can successfully be applied to tomographic image data from real battery anodes and cathodes, which are composed of particle systems with very different morpohological properties. Finally, we show how the results of the segmentation algorithm can be used for structural analysis.

Pore space extraction and characterization of sack paper using µ-CT.

We show that attenuation X-ray microcomputed tomography (µ-CT) offers a route to extract the three-dimensional pore space of paper reliably enough to distinguish samples of the same kind of paper. Here, we consider two sack kraft papers for cement bags with different basis weights and thicknesses. Sample areas of approximately 5 mm2 with a resolution of 1.5 µm are considered, i.e. sizes that exceed sample areas of 2 mm2 for which the pore structure was previously studied in the literature. The image segmentation is based on indicator kriging as a local method that removes ambiguities in assigning voxels as pore or as fibre. The microstructures of the two samples are statistically compared in terms of descriptors such as sheet thickness, porosity, fractions of externally accessible pores and mean geodesic tortuosity. We demonstrate that a quantitative comparison of samples in terms of porosity and thickness requires a common definition of the sheet surfaces. Finally, the statistical pore space analysis based on the µ-CT scans reliably reveals structural differences between the two paper samples, but only when several descriptors are used. LAY DESCRIPTION: This paper is a seemingly abundant material. Its intrinsic porosity enables a vast number of commercial applications. Particularly packing products, e.g. cement bags, often incorporate sack kraft paper due to its high porosity and its additional mechanical strength. A direct quantification of the porosity of sack kraft papers is, hence, particularly desirable. However, experimental quantification of paper porosity or its pore network properties is difficult and often highly indirect. A nondestructive statistical analysis of the 3D microstructure holds the promise to directly assess the pores. In particular, X-ray microcomputed tomography (µ-CT), frequently with sub-µm resolution, has been established as a method to study the fibre and pore structure of paper. The question arises, whether statistical analysis of the microstructure based on µ-CT imaging is sufficient to reliably distinguish between different sack kraft papers. Here, we explore whether the pore structure of paper can be extracted and statistically analysed for larger sample areas despite the fact that a larger sample size directly translates into a lower resolution of the µ-CT scan. We expect that a large sample size increases the region of interest on the basis of which samples can be better distinguished. A lowered resolution poses a severe challenge for the reliable identification of voxel data as pores or as fibres, because the contrast between paper fibres (made of cellulose) and air, which is established due to X-ray absorption, is weak. We show that we can reliably assign each voxel by using an indicator kriging as a two-step method. This method performs an initial voxel identification based on the overall distribution of measured grey values and refines the identification by inspecting the local environment of each voxel. For the pore space extracted in such a way, we can then compute quantities that are related to the geometry and connectivity properties of the pores. Furthermore, we address a paper-born challenge for such an analysis, i.e. we cannot always unambiguously tell whether a pore is located inside the paper sheet or at the surface of the paper. The way the paper surfaces are extracted from the microstructure decisively determines the final specifications of the predicted properties. A significant distinction of the samples is only possible when comparing the properties of the pore network.

Analysis of the 3D microstructure of experimental cathode films for lithium-ion batteries under increasing compaction.

It is well known that the microstructure of electrodes in lithium-ion batteries has an immense impact on their overall performance. The compaction load during the calendering process mainly determines the resulting morphology of the electrode. Therefore, NCM-based cathode films from uncompacted (0 MPa) to most highly compacted (1000 MPa) were manufactured, which corresponds to global porosities ranging from about 50% to 18%. All samples have been imaged using synchrotron tomography. These image data allow an extensive analysis of the 3D cathode microstructure with respect to increasing compaction. In addition, the numerous microstructural changes can be quantified using several characteristics describing the morphology of cathode samples. Three characteristics, namely global porosity, global volume fraction of active material and mean cathode thickness, are compared to experimental results. In addition, the microstructural analysis by means of 3D image data and image processing techniques allows the investigation of characteristics which are hard or impossible to ascertain by experiments, for example the continuous pore size distribution and the sphericity distribution of NCM-particles. Finally, the dependency of microstructural characteristics on compaction load is described by the help of parametric probability distributions. This approach can be used, for example, to predict the distribution of a certain characteristic for an 'unknown' compaction load, which is a valuable information with regard to the optimization and development process of NCM-cathodes in lithium-ion batteries. LAY DESCRIPTION: It is well known that the microstructure of electrodes in lithium-ion batteries has an immense impact on their overall performance. The manufacturing of the batteries includes the so-called calendering, where the electrodes are compressed with a certain pressure, which is called compaction load. This process step mainly determines the resulting morphology of the electrode and thus the properties of the battery. Therefore, eight cathodes with different compaction loads were manufactured and imaged by synchrotron tomography, which leads to 3D images containing detailed information about the inner structure of the cathode. This image data allows an extensive analysis of the 3D cathode microstructure with respect to increasing compaction. In order to quantify the microstructural changes we use several characteristics describing diverse properties of the morphology. Furthermore, the 3D image data can be used for the computation of characteristics which can not be determined by experiments. Therefore, 3D image data allows us to understand how the microstructure of cathodes is influenced by the compaction load. Finally, we are able to predict the distribution of a certain characteristic for arbitrary compaction loads. This information is valuable with regard to the development of improved lithium-ion batteries.

Phase Locking the Spin Precession in a Storage Ring.

This Letter reports the successful use of feedback from a spin polarization measurement to the revolution frequency of a 0.97 GeV/c bunched and polarized deuteron beam in the Cooler Synchrotron (COSY) storage ring in order to control both the precession rate (≈121 kHz) and the phase of the horizontal polarization component. Real time synchronization with a radio frequency (rf) solenoid made possible the rotation of the polarization out of the horizontal plane, yielding a demonstration of the feedback method to manipulate the polarization. In particular, the rotation rate shows a sinusoidal function of the horizontal polarization phase (relative to the rf solenoid), which was controlled to within a 1 standard deviation range of σ=0.21 rad. The minimum possible adjustment was 3.7 mHz out of a revolution frequency of 753 kHz, which changes the precession rate by 26 mrad/s. Such a capability meets a requirement for the use of storage rings to look for an intrinsic electric dipole moment of charged particles.

Present status of laboratory diagnosis of human taeniosis/cysticercosis in Europe.

Human cysticercosis (CC) is a parasitic zoonosis caused by the larval stage (cyst) of the Taenia solium. Cysts can establish in the human central nervous system (neurocysticercosis, NCC) and other organs and tissues; they also develop in pigs, the natural intermediate host. Human taeniosis may be caused by T. solium, Taenia saginata and Taenia asiatica tapeworms; these infections are usually asymptomatic, but show a significant relevance as they perpetuate the parasites' life cycle, and, in the case of T. solium, they are the origin of (N)CC. In European Union (EU) member states and associated countries, the occurrence of autochthonous T. solium cases is debated, and imported cases have significantly increased lately; the status of T. asiatica has been never reported, whereas T. saginata is prevalent and causes an economic impact due to condemned carcasses. Based on their effects on the EU society, the specific diagnosis of these pathologies is relevant for their prevention and control. The aims of this study were to know the diagnostic tests used in European laboratories for human taeniosis/cysticercosis by means of a questionnaire, to determine potential gaps in their detection, and to obtain preliminary data on the number of diagnosed taeniosis/CC cases.

Quantitative comparison of segmentation algorithms for FIB-SEM images of porous media.

Focused ion beam tomography has proven to be capable of imaging porous structures on a nano-scale. However, due to shine-through artefacts, common segmentation algorithms often lead to severe dislocation of individual structures in z-direction. Recently, a number of approaches have been developed, which take into account the specific nature of focused ion beam-scanning electron microscope images for porous media. In the present study, we analyse three of these approaches by comparing their performance based on simulated focused ion beam-scanning electron microscope images. Performance is measured by determining the amount of misclassified voxels as well as the fidelity of structural characteristics. Based on this analysis we conclude that each algorithm has certain strengths and weaknesses and we determine the scenarios for which each approach might be the best choice.

Automatic quantification of angiogenesis in 2D sections: a precise and timesaving approach.

INTRODUCTION: The standardized characterization of angiogenesis is crucial in the field of tissue engineering as sufficient blood supply is the limiting factor of mass transfer. However, reliable algorithms that provide a straight forward and observer-independent assessment of new vessel formation are still lacking. We propose an automatic observer-independent quantitative method (including downloadable source code) to analyze vascularization using two-dimensional microscopic images of histological cross-sections and advanced postprocessing, based on a 'positive- and negative-experts' model and a (corrected) nearest neighbour classification, in a vascularized tissue engineering model. MATERIALS AND METHODS: An established angioinductive rat arteriovenous loop model was used to compare the new automatic analysis with a common 2D method and a µCT algorithm. Angiogenesis was observed at three different time points (5, 10 and 15 days). RESULTS: In line with previous results, formation of functional new vessels that arose from the venous graft was evident within the three-dimensional construct and a significant (p < 0.05) increase in vessel count and area was observed over time. The proposed automatic analysis obtained precise values for vessel count and vessel area that were similar to the manually gained data. The algorithm further provided vectorized parameterization of the newly formed vessels for advanced statistical analysis. Compared to the µCT-based three-dimensional analyses, the presented two-dimensional algorithm was superior in terms of small vessel detection as well as cost and time efficiency. CONCLUSIONS: The quantitative evaluation method, using microscopic images of stained histological sections, 'positive- and negative-experts'-based vessel segmentation, and nearest neighbour classification, provides a user-independent and precise but also time- and cost-effective tool for the analysis of vascularized constructs. Our algorithm, which is freely available to the public, outperforms previous approaches especially in terms of unambiguous vessel classification and statistical analyses.

Full thermoelectric characterization of InAs nanowires using MEMS heater/sensors.

Precise measurements of a complete set of thermoelectric parameters on a single indium-arsenide nanowire (NW) have been performed using highly sensitive, micro-fabricated sensing devices based on the heater/sensor principle. The devices were fabricated as micro electro-mechanical systems consisting of silicon nitride membranes structured with resistive gold heaters/sensors. Preparation, operation and characterization of the devices are described in detail. Thermal decoupling of the heater/sensor platforms has been optimized reaching thermal conductances as low as 20 nW K(-1) with a measurements sensitivity below 20 nW K(-1). The InAs NWs were characterized in terms of thermal conductance, four-probe electrical conductance and thermopower (Seebeck coefficient), all measured on a single NW. The temperature dependence of the parameters determining the thermoelectric figure-of-merit of an InAs NW was acquired in the range 200-350 K featuring a minor decrease of the thermal conductivity from 2.7 W (m K)(-1) to 2.3 W (m K)(-1).

Aerobic cloacal and pharyngeal bacterial flora in six species of free-living birds.

AIMS: The purpose of this study was to investigate the culturable aerobic pharyngeal and cloacal bacterial flora of free-living birds, to determine the physiological bacterial microbiota, to identify possible interactions between feeding behaviour and the composition of the pharyngeal and cloacal microflora and to investigate the occurrence of pathogenic bacteria. METHODS AND RESULTS: Cloacal and pharyngeal swabs of 167 free-living birds, including water rails (Rallus aquaticus), spotted crakes (Porzana porzana), mute swans (Cygnus olor), barn swallows (Hirundo rustica), reed warblers (Acrocephalus scirpaceus) and black cormorants (Phalacrocorax carbo) from Germany, were cultured to determine the prevalence of aerobic bacteria. Statistical analysis of bacterial findings and feeding behaviour was performed. A widespread soil and water bacteria were isolated, which are expected to be present in the habitat and food. However, some potentially avian- and human-pathogenic bacteria, such as Aeromonas hydrophila, Elizabethkingia meningoseptica, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli, were also recovered. CONCLUSIONS: Free-living birds of the examined species harbour several environmental bacteria, which could be facultative pathogenic. SIGNIFICANCE AND IMPACT OF THE STUDY: Prevalence of bacteria in healthy free-living birds of the species included in this survey is influenced by environmental and alimentary factors.

Infection-induced anaemia: a cross-sectional study of 14,636 German travellers aged 20-49 years.

BACKGROUND: Anaemia is a frequently diagnosed condition which can develop as a consequence of numerous factors, including infectious diseases (IDs). Travelling, especially in sub-/tropical regions, leads to an elevated risk of contracting IDs. The aim of our study was to assess the epidemiological significance of IDs in inducing anaemia among a large cohort of returned travellers. METHODS: This was a cross-sectional study in which data on 17,009 returned travellers aged 20-49 years who consulted the travel medicine clinic of the University of Munich between 1999 and 2011 were retrieved and analysed. RESULTS: Of the returned travellers, 8.3 % (6.0 % of males/10.4 % of females) were diagnosed with anaemia. The prevalence of anaemia was significantly elevated among patients of African (21.4/28.3 %) and Asian (11.6/15.7 %) origin. When the study population was restricted to the 14,636 travellers of German origin, 7.1 % of the returned travellers (4.6/9.6 %) were diagnosed with anaemia. The prevalence was significantly elevated among patients who travelled for >30 days (5.7 of males/10.6 % of females) and for male travellers visiting friends and relatives (7.7 %). However, these correlations were confounded by malaria. The prevalence of anaemia was significantly elevated only among returned travellers diagnosed with malaria (36.1 of males/26.9 % of females) and with symptomatic intestinal Entamoeba histolytica infections (30.0/33.3 %). CONCLUSION: Following the exclusion of confounding by malaria from the statistical analysis, the prevalence of anaemia was found to be significantly elevated among patients of African and Asian origin, and among patients of German origin who had travelled for >30 days, it could be mainly attributable to chronic, long-lasting causes. Although more than 550 travel-associated IDs were assessed in our study, only symptomatic intestinal Entamoeba histolytica infections and, to an even larger extent, malaria were determined to be of epidemiological significance for inducing anaemia among travellers.

Evidence for the transmission of Salmonella from reptiles to children in Germany, July 2010 to October 2011.

This study examines the Salmonella status in reptiles kept in households with children suffering from gastroenteritis due to an exotic Salmonella serovar, to obtain information on possible transmission paths. A number of affected households (n=79) were contacted, and almost half (34/79) comprised at least one reptile in the home. Of the households, 19 were further studied, whereby a total of 36 reptiles were investigated. Samples were taken from the reptiles including the oral cavity, the cloaca, the skin and, in the case of lizards, the stomach, and isolation of Salmonella strains was performed using repeated enrichment and typing. Where the Salmonella serovars of the infected child and the reptile were identical, typing was followed by pulsed-field gel electrophoresis (PFGE). Bearded dragons (Pogona vitticeps) constituted 19 of 36 examined reptiles. Altogether 319 Salmonella isolates were investigated and 24 different serovars identified in the reptiles. In 15 of 19 households, an identical serovar to the human case was confirmed in at least one reptile (including 16 of all 19 bearded dragons examined). The results demonstrate that reptiles and especially bearded dragons shed various Salmonella serovars including those isolated from infected children in the respective households. Hygiene protocols and parents' education are therefore highly necessary to reduce the risk of transmission. From a terminological point of view, we propose to call such infections 'Reptile-Exotic-Pet-Associated-Salmonellosis' (REPAS).

Erosion behaviour of human, bovine and equine dental hard tissues.

Dental hard tissues from different species are used in dental research, but little is known about their comparability. The aim of this study was to compare the erosive behaviour of dental hard tissues (enamel, dentin) obtained from human, bovine and equine teeth. In addition, the protective effect of the pellicle on each hard tissue under erosive conditions was determined. In situ pellicle formation was performed for 30 min on enamel and dentin samples from all species in four subjects. Calcium and phosphate release was assessed during 120 s of HCl incubation on both native and pellicle-covered enamel and dentin samples. SEM and TEM were used to examine surface changes in native enamel and dentin samples after acid incubation and the ultrastructure of the pellicle before and after erosive exposure. In general, bovine enamel and dentin showed the highest degree of erosion after acid exposure compared to human and equine samples. Erosion of human primary enamel tended to be higher than that of permanent teeth, whereas dentin showed the opposite behaviour. SEM showed that eroded equine dentin appeared more irregular than human or bovine dentin. TEM studies showed that primary enamel appeared to be most susceptible to erosion.

Report of three patients with extensive neurocysticercosis in rural southern Tanzania: neurological, serological and neuroradiological findings.

BACKGROUND: Neurocysticercosis (NCC) is common in eastern Africa, but disease presentation varies considerably. Most patients have single or few NCC-typical lesions in their brain but some present with a large number of lesions. We present three patients with positive antibody-based serology for Taenia solium cysticercosis screened at the Vwawa district hospital, Mbozi district, southern Tanzania, in whom extensive NCC was confirmed by neuroimaging. CASE PRESENTATIONS: Patient 1 was a 55-year-old female from the tribe Malila smallholder farmer who has had four generalized tonic-clonic epileptic seizures over a period of 11 years and one episode of transient left hemiparesis one year before seizure onset. The patient also reported monthly to weekly episodes of severe, progressive, unilateral headache. The computed tomography (CT) scan of the brain showed 25 NCC lesions of which 15 were in the vesicular stage. Patient 2 was a 30-year-old male from tribe Nyha mechanic who reported monthly episodes of moderate to severe, progressive, bilateral headache, but no epileptic seizures. The CT scan showed 63 NCC lesions of which 50 were in the vesicular stage. Patient 3 was a 54-year-old female from the tribe Malila smallholder farmer who suffered from frequent generalized tonic-clonic epileptic seizures with potential signs of focal seizure onset. She also reported weekly to daily episodes of severe, progressive, unilateral headache. The CT scan showed 29 NCC lesions of which 28 were in the vesicular stage. CONCLUSIONS: Clinical presentation of NCC with multiple brain lesions varies considerably ranging from few epileptic seizures and severe headache to severe epilepsy with frequent epileptic seizures. Individuals with neurological signs/symptoms that may be due to NCC, based for example on epidemiological criteria or serological evidence of cysticercosis, are recommended to undergo neuroimaging before anthelminthic treatment is considered.

Post-acute phase and sequelae management of epidermal necrolysis: an international, multidisciplinary DELPHI-based consensus.

BACKGROUND: Long-term sequelae are frequent and often disabling after epidermal necrolysis (Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)). However, consensus on the modalities of management of these sequelae is lacking. OBJECTIVES: We conducted an international multicentric DELPHI exercise to establish a multidisciplinary expert consensus to standardize recommendations regarding management of SJS/TEN sequelae. METHODS: Participants were sent a survey via the online tool "Survey Monkey" consisting of 54 statements organized into 8 topics: general recommendations, professionals involved, skin, oral mucosa and teeth, eyes, genital area, mental health, and allergy workup. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). Results were analyzed according to the RAND/UCLA Appropriateness Method. RESULTS: Fifty-two healthcare professionals participated. After the first round, a consensus was obtained for 100% of 54 initially proposed statements (disagreement index < 1). Among them, 50 statements were agreed upon as 'appropriate'; four statements were considered 'uncertain', and ultimately finally discarded. CONCLUSIONS: Our DELPHI-based expert consensus should help guide physicians in conducting a prolonged multidisciplinary follow-up of sequelae in SJS-TEN.