ABSTRACT
Spitzoid melanoma is very rare tumour in the pediatric population, with clinical and non-uniform behaviour, different from adult melanoma [1]. It can be difficult to differentiate an atypical Spitz nevus from a Spitzoid melanoma, resulting in diagnostic problems. In addition, in our clinical case, the COVID-19pandemiccaused significant delays both in the diagnosis and in the surgical treatment of our patient. We present the clinical case of a 4-year-old child suffering from a localized polypoid cutaneous neoformation on the dorsum of the left hand, which started immediately before the lockdown and steadily increased during the COVID-19 pandemic. After a general clinical framing, the child underwent an excisional biopsy at our Department of Plastic and Reconstructive Surgery, at the Policlinico of Foggia. Subsequently, two independent anatomic pathology groups examined the specimen. Definitive diagnosis was made only after careful genetic analysis in combination with supporting histological and immunohistochemical examinations. This clinical case shows how during the pandemic we have been facing advanced forms of tumours, compared to the previous period and highlight show an interdisciplinary and multicenter collaboration allowed a quick diagnosis of certainty, demonstrating the utility of molecular pathology as a fundamental aid in clinical/surgical practice. © 2022 The Authors
ABSTRACT
The Covid-19 pandemic emergency has further highlighted the centrality of primary care in health systems, fostering a new reform process towards new integrated community services called 'Case della Comunità'. In the path dependency logic, the new proposal is part of regionalized reform paths, centered on the Case della Salute. The study analyzes three regional experiences (Piemonte, Marche, Puglia), investigating the continuity or fracture paths between implemented and announced reforms. The results highlight the heterogeneity in the implementation processes of the Case della Salute at regional level, both in terms of terminology and in the characteristics of the services, with marked criticalities in the integration paths of primary care with the rest of the community services, confirming the criticality in the transposition and implementation at the regional level of national policies. © 2021 Franco Angeli Edizioni. All rights reserved.
ABSTRACT
The Covid-19 pandemic emergency has further highlighted the centrality of primary care in health systems, fostering a new reform process towards new integrated community services called 'Case della Comunità'. In the path dependency logic, the new proposal is part of regionalized reform paths, centered on the Case della Salute. The study analyzes three regional experiences (Piemonte, Marche, Puglia), investigating the continuity or fracture paths between implemented and announced reforms. The results highlight the heterogeneity in the implementation processes of the Case della Salute at regional level, both in terms of terminology and in the characteristics of the services, with marked criticalities in the integration paths of primary care with the rest of the community services, confirming the criticality in the transposition and implementation at the regional level of national policies. © 2021 Franco Angeli Edizioni. All rights reserved.
ABSTRACT
The Covid-19 pandemic has suddenly and tragically placed human society in a new social reality in which nature seems to rebel against technological domination and has knocked out the social organization and the health systems of all the countries involved. In this paper it will be analyzed the differentiated impact of Covid-19 in Italy as a result of the regionalization of health systems as well as the role that the state and regions have assumed in the two different phases of pandemic development. The focus of the analysis is the Puglia region, a region of the South, and the main criticalities that emerged;it will also deal with the measures and responses implemented by the regional health systems (SSR), such as territorial organizational models, to combat the spread of pandemics and / or models of innovative management for the continuity of care for chronic diseases. Copyright © FrancoAngel
ABSTRACT
2020 will be remembered worldwide for the outbreak of Coronavirus disease (COVID-19), which quickly spread until it was declared as a global pandemic. The main protease (Mpro) of SARS-CoV-2, a key enzyme in coronavirus, represents an attractive pharmacological target for inhibition of SARS-CoV-2 replication. Here, we evaluated whether the anti-inflammatory drug Ibuprofen, may act as a potential SARS-CoV-2 Mpro inhibitor, using an in silico study. From molecular dynamics (MD) simulations, we also evaluated the influence of ionic strength on the affinity and stability of the Ibuprofen-Mpro complexes. The docking analysis shows that R(-)Ibuprofen and S(+)Ibuprofen isomers can interact with multiple key residues of the main protease, through hydrophobic interactions and hydrogen bonds, with favourable binding energies (-6.2 and -5.7 kcal/mol, respectively). MM-GBSA and MM-PBSA calculations confirm the affinity of these complexes, in terms of binding energies. It also demonstrates that the ionic strength modifies significantly their binding affinities. Different structural parameters calculated from the MD simulations (120 ns) reveal that these complexes are conformational stable in the different conditions analysed. In this context, the results suggest that the condition 2 (0.25 NaCl) bind more tightly the Ibuprofen to Mpro than the others conditions. From the frustration analysis, we could characterize two important regions (Cys44-Pro52 and Linker loop) of this protein involved in the interaction with Ibuprofen. In conclusion, our findings allow us to propose that racemic mixtures of the Ibuprofen enantiomers might be a potential treatment option against SARS-CoV-2 Mpro. However, further research is necessary to determinate their possible medicinal use.Communicated by Ramaswamy H. Sarma.