Chronic Recurrent Multifocal Osteomyelitis: A Case Report with Atypical Presentation.

INTRODUCTION: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory condition. The clinical picture consists of sterile osteomyelitis, typically with multiple-site lesions in the metaphysis of long bones and not uncommonly, symmetrical bone involvement. It is a poorly understood entity, whose prognosis, etiology and ideal treatment are still controversial. The authors report a case of unifocal presentation with an atypical location. CASE REPORT: A previously healthy 12-year-old Caucasian girl came to our institution due to progressive pain on her left thigh for the previous 3 months. The initial X-ray showed a permeative, diaphyseal lesion of her left femur, with marked periosteal reaction. The differential initially included Ewing's sarcoma, osteosarcoma, subacute osteomyelitis, and Langerhans cell histiocytosis. Needle and open biopsies demonstrated the presence of chronic inflammatory infiltrate, with fibrosis, but no signs of neoplastic disease. Serologic and microbiological studies failed to demonstrate an infectious etiology. The patient was treated with nonsteroid anti-inflammatories, corticosteroids, and bisphosphonates for 6 months. Although no antibiotics were employed, the patient showed clinical and radiological improvement, at 18-month follow-up. CONCLUSIONS: CRMO is a rare condition, and the absence of specific features constitutes a diagnostic challenge. A high level of suspicion is paramount to avoid unnecessary biopsies and repeated antibiotic regimens. Unifocal presentation of this disease, atypical locations, and absence of recurrence have all been previously reported, with the evidence pointing to a shared etiological process with no distinction being made between these variants. For this reason, the authors believe that the term "nonbacterial osteomyelitis" might be a more all-embracing designation.info:eu-repo/semantics/publishedVersio

Extended-release niacin increases anti-apolipoprotein A-I antibodies that block the antioxidant effect of high-density lipoprotein-cholesterol: the EXPLORE clinical trial.

Extended-release niacin (ERN) is the most effective agent for increasing high-density lipoprotein-cholesterol (HDL-C). Having previously identified anti-HDL antibodies, we investigated whether ERN affected the antioxidant capacity of HDL and whether ERN was associated with the production of antibodies against HDL (aHDL) and apolipoprotein A-I (aApoA-I). METHODS: Twenty-one patients older than 18 years, with HDL-C ≤40 mg dl-1 (men) or ≤50 mg dl-1 (women) were randomly assigned to receive daily ERN (n = 10) or placebo (n = 11) for two sequential 12-week periods, with 4 weeks of wash-out before cross-over. Primary outcome was change of paraoxonase-1 (PON1) activity and secondary outcomes were changes in aHDL and aApoA-I antibodies. Clinical Trial Unique Identifier: EudraCT 2006-006889-42. RESULTS: The effect of ERN on PON1 activity was nonsignificant (coefficient estimate 20.83 U l-1 , 95% confidence interval [CI] -9.88 to 51.53; P = 0.184). ERN was associated with an increase in HDL-C levels (coefficient estimate 5.21 mg dl-1 , 95% CI 1.16 to 9.25; P = 0.012) and its subclasses HDL2 (coefficient estimate 2.46 mg dl-1 , 95% CI 0.57 to 4.34; P = 0.011) and HDL3 (coefficient estimate 2.73 mg dl-1 , 95% CI 0.47 to 4.98; P = 0.018). ERN was significantly associated with the production of aApoA-I antibodies (coefficient estimate 0.25 μg ml-1 , 95% CI 0.09-0.40; P = 0.001). aApoA-I titres at baseline were correlated with decreased PON activity. CONCLUSIONS: The rise in HDL-C achieved with ERN was not matched by improved antioxidant capacity, eventually hampered by the emergence of aApoA-I antibodies. These results may explain why Niacin and other lipid lowering agents fail to reduce cardiovascular risk.info:eu-repo/semantics/publishedVersio

Simulation of Chua's Circuit by Means of Interval Analysis

The Chua's circuit is a paradigm for nonlinear scientific studies. It is usually simulated by means of numerical methods under IEEE 754-2008 standard. Although the error propagation problem is well known, little attention has been given to the relationship between this error and inequalities presented in Chua's circuit model. Taking the average of round mode towards $+\infty$ and $-\infty$, we showed a qualitative change on the dynamics of Chua's circuit.Comment: 6th International Conference on Nonlinear Science and Complexity - S\~ao Jos\'e dos Campos, 2016, p. 1-

Morphological analysis of Yarrowia lipolytica under stress conditions through image processing

Yarrowia lipolytica is an aerobic microrganism capable to produce important metabolites, has an intense secretory activity which drives efforts to be employed in industry (as a biocatalyst), in molecular biology and genetics studies. Dimorphism is refeered to fungi ability to growth in two distinct forms, usually as single oval cells os as a filament and to be reversible between each one. The cell shape is controlled by environmental factors and has been seeked by some authors [1,2,3]. Y. lipolytica has been considered an adequate model for dimorphism studies in yeasts since it has an efficient system for transformation and is easy to distinct between its morphological forms, on opposite to S. cerevisiae that do not produce true filaments and exhibits pseudohyphae growth under nitrogen limited conditions. Y. lipolytica has an hyphae diameter corresponding 60 to 100% of its single cell stage [4,5]. It is believed that Y. lipolytica dimorphism is related to defense mechanism from adverse conditions. The aim of this work resides on investigate morphological changes in Y. lipolytica under thermal and oxidative stress conditions. Yarrowia lipolytica (IMUFRJ 50682) was cultivated in YPD medium (glucose 2%, peptone 0.64%, yeast extract 1%) at 29oC and 160 rpm. Thermal stress experiments were carried employing a temperature shift (37oC / 1 h.). For oxidative ones, an addition of H2O2 was used to reach final concentration of 10mM. Both stress conditions were applied at exponential growth phase. Morphology was observed in a optic microscope (Axiolab, Zeiss) and cell characteristics were determined employing image processing analysis (Matlab v. 6.1, The Mathworks Inc.) and comparisons were carried on to a control system. A net increase around 22% on hyphae formation was detected as well as a significant increment in its length in relation to control system, when both thermal and oxidative stress was applied. The results herein obtained drives to consider a possible relationship between dimorphism and a cell response mechanism to stress conditions.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq); Fundação para a Ciência e a Tecnologia (FCT); CAPES

Superstar Returns

We study long-term returns on residential real estate in twenty-seven “superstar” cities in fifteen countries over 150 years. We find that total returns in superstar cities are close to 100 basis points lower per year than in the rest of the country. House prices tend to grow faster in the superstars, but rent returns are substantially greater outside the big agglomerations, resulting in higher long-run total returns. The excess returns outside the superstars can be rationalized as a compensation for risk, especially for higher covariance with income growth and lower liquidity. Superstar real estate is comparatively safe

Superstar Returns

We study long-term returns on residential real estate in 27 "superstar" cities in 15 countries over 150 years. We find that total returns in superstar cities are close to 100 basis points lower per year than in the rest of the country. House prices tend to grow faster in the superstars, but rent returns are substantially greater outside the big agglomerations, resulting in higher long-run total returns. The excess returns outside the superstars can be rationalized as a compensation for risk, especially for higher co-variance with income growth and lower liquidity. Superstar real estate is comparatively safe