Nasal manifestations in granulomatosis with polyangiitis: a case report and review of the literature

Granulomatosis with polyangiitis (GPA) is an anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides of medium and small arteries, characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tract with coexist- ing glomerulonephritis. We report a case of GPA in a patient presenting with a six-month history of spontaneous epistaxis, nasal obstruction and frontal headache. Nasal endoscopy showed a large nasal septum perforation and an anterior translucid mass in the right nasal fossa. Findings were confirmed by computed tomography (CT) scan with contrast. The patient underwent func- tional transnasal endoscopic removal of the mass; histological examination showed tissue features suggestive of GPA; dosage of c-ANCA e p-ANCA antibodies confirmed GPA diagnosis. Nasal septum perforation has long been recognized as a feature of GPA, in which granulomatous destruction of nasal cartilage can result in perforation and saddle-nose deformity. Prompt diagno- sis of GPA is important to initiate therapy which may be life-saving and organ sparing

Identifying conformational changes with site-directed spin labeling reveals that the GTPase domain of HydF is a molecular switch

[FeFe]-hydrogenases catalyse the reduction of protons to hydrogen at a complex 2Fe[4Fe4S] center called H-cluster. The assembly of this active site is a multistep process involving three proteins, HydE, HydF and HydG. According to the current models, HydF has the key double role of scaffold, upon which the final H-cluster precursor is assembled, and carrier to transfer it to the target hydrogenase. The X-ray structure of HydF indicates that the protein is a homodimer with both monomers carrying two functional domains: a C-terminal FeS cluster-binding domain, where the precursor is assembled, and a N-terminal GTPase domain, whose exact contribution to cluster biogenesis and hydrogenase activation is still elusive. We previously obtained several hints suggesting that the binding of GTP to HydF could be involved in the interactions of this scaffold protein with the other maturases and with the hydrogenase itself. In this work, by means of site directed spin labeling coupled to EPR/PELDOR spectroscopy, we explored the conformational changes induced in a recombinant HydF protein by GTP binding, and provide the first clue that the HydF GTPase domain could be involved in the H-cluster assembly working as a molecular switch similarly to other known small GTPases

Prenatal exposure to tobacco and alcohol are associated with chronic daily headaches at childhood: a population-based study

The influence of prenatal events on the development of headaches at childhood has not been investigated and is the scope of our study. Of 2,173 children identified as the target sample, consents and analyzable data were provided by 1,440 (77%). Parents responded to a standardized questionnaire with a validated headache module and specific questions about prenatal exposures. Odds of chronic daily headache (CDH) were significantly higher when maternal tabagism was reported. When active and passive smoking were reported, odds ratio (OR) of CDH were 2.29 [95% confidence intervals (CI)=1.6 vs. 3.6)]; for active tabagism, OR=4.2 (95% CI=2.1-8.5). Alcohol use more than doubled the chance of CDH (24% vs. 11%, OR=2.3, 95% CI=1.2-4.7). In multivariate analyses, adjustments did not substantially change the smoking/CDH association. Prenatal exposure to tobacco and alcohol are associated with increased rates of CDH onset in preadolescent children

Recovery from repeated sudden hearing loss in a patient with Takayasu’s arteritis treated with hyperbaric oxygen therapy: the first report in the literature

Hearing loss has been rarely reported in Takayasu's arteritis, presents as sudden sensorineural hearing loss and usually responds well to corticosteroid therapy. Hyperbaric Oxygen Therapy is commonly used as a supplementary treatment to corticosteroids for sudden hearing loss. We present the case of a woman with Takayasu's arteritis who had two episodes of hearing loss involving one ear at a time with a 11-month delay between each episode. During the first episode, the patient was treated with high-dose intramuscular corticosteroids with a temporary improvement of auditory threshold, that deteriorated close to previous level 14 days after cessation of therapy. In the second episode, Hyperbaric Oxygen Therapy was associated to corticosteroids, with a significant, longer term improvement in both ears, including the one that had shown to be unresponsive to previous pharmacologic therapy. Oxygen therapy could have played a role in hearing restoration in this patient, as it could have acted synergically with corticosteroids amplifying their effect

Surface-acoustic-wave driven planar light-emitting device

Electroluminescence emission controlled by means of surface acoustic waves (SAWs) in planar light-emitting diodes (pLEDs) is demonstrated. Interdigital transducers for SAW generation were integrated onto pLEDs fabricated following the scheme which we have recently developed. Current-voltage, light-voltage and photoluminescence characteristics are presented at cryogenic temperatures. We argue that this scheme represents a valuable building block for advanced optoelectronic architectures

Weekly versus three weeks chemotherapy for advanced ovarian cancer. A meta-analysis

Aim: Three weeks paclitaxel and carboplatin has been considered the standard of care for primary treatment of ovarian cancer (OC). Whether weekly therapy will further improve the clinical outcomes or not is still unclear. We conducted a meta-analysis to compare the two regimens. Method: Articles were selected with a systematic approach, using PubMed databases. Trials concerning comparison between carboplatin plus weekly paclitaxel (dose-dense regimen) and carboplatin plus paclitaxel every 3 weeks were considered. Outcomes included overall survival (OS), progression free survival (PFS) and severe acute toxicity. Results: Dose-dense regimen was associated with significant improvement of PFS compared with standard schedule, with HR of 0.73 (95% CI 0.61-0.88, p = 0.001). There was no difference in OS between treatment regimens (HR 0.95, 95% CI 0.77-1.16, p=0.06), as well as in term of severe acute toxicity. Conclusion: Dose-dense regimen is superior to standard schedule in terms of PFS. Further studies are necessary to firmly confirm this evidence in advanced OC treatment

Severe bloodstream infection due to KPC-producer e coli in a renal transplant recipient treated with the double-carbapenem regimen and analysis of in vitro synergy testing a case report

Transplant recipients are at high risk of infections caused by multidrug resistant microorganisms. Due to the limited thera- peutic options, innovative antimicrobial combinations against carbape- nem-resistant Enterobacteriaceae causing severe infections are necessary. A 61-year-old woman with a history of congenital solitary kidney underwent renal transplantation. The postoperative course was compli- cated by nosocomial pneumonia due to Stenotrophomonas maltophilia and pan-sensitive Escherichia coli, successfully treated with antimicrobial therapy. On postoperative day 22, diagnosis of surgical site infection and nosocomial pneumonia with concomitant bacteremia due to a Kle- bisella pneumoniae carbapenemase-producer E coli was made. The patient was treated with the double-carbapenem regimen (high dose of merope- nem plus ertapenem) and a potent synergistic and bactericidal activity of this un-conventional therapeutic strategy was observed in vitro. Despite a microbiological response with prompt negativity of blood cultures, the patient faced a worse outcome because of severe hemorrhagic shock. The double-carbapenem regimen might be considered as a rescue therapy in those subjects, including transplant recipients, in whom previous antimicrobial combinations failed or when colistin use might be discouraged. Performing in vitro synergy testing should be strongly encouraged in cases of infections caused by pan-drug resistant strains, especially in high-risk patients

Acoustic charge transport in n-i-n three terminal device

We present an unconventional approach to realize acoustic charge transport devices that takes advantage from an original input region geometry in place of standard Ohmic input contacts. Our scheme is based on a n-i-n lateral junction as electron injector, an etched intrinsic channel, a standard Ohmic output contact and a pair of in-plane gates. We show that surface acoustic waves are able to pick up electrons from a current flowing through the n-i-n junction and steer them toward the output contact. Acoustic charge transport was studied as a function of the injector current and bias, the SAW power and at various temperatures. The possibility to modulate the acoustoelectric current by means of lateral in-plane gates is also discussed. The main advantage of our approach relies on the possibility to drive the n-i-n injector by means of both voltage or current sources, thus allowing to sample and process voltage and current signals as well.Comment: 9 pages, 3 figures. Submitted to Applied Physics Letter

Multi-disciplinary analysis and optimization Java tool for aircraft design

The first stages of the aircraft design process require to carry out multi-disciplinary analyses as fast as possible, and with a certain grade of accuracy. During the conceptual and the preliminary phases, the goal is to search for the design that best fulfils the requirements. This work presents a Java framework, named JPAD, developed at the University of Naples Federico II by the Design of Aircraft and Flight technologies research group (DAF) to perform multi-disciplinary analysis and optimization of transport aircraft. This paper describes all the JPAD capabilities, focusing on the sensitivity analyses and optimization modules. At the end, a case study concerning the optimization of a regional turboprop aircraft model similar to the well-known ATR72 will be presented