De novo Cryoglobulinaemic Mononeuritis Multiplex during Treatment of Chronic Hepatitis C Infection: A Viral Effect or Induced by Pegylated Interferon Alpha?

Cryoglobulinaemic mononeuritis multiplex (MNM) is an extrahepatic manifestation of chronic hepatitis C virus (HCV) infection for which interferon-based antiviral therapy is currently the treatment of choice. Rarely MNM can be associated with HCV treatment though generally in the setting of pre-existing cryoglobulinaemia and detectable HCV viraemia. We report an unusual case of de novo MNM occurring late during the course of pegylated interferon and ribavirin therapy for chronic HCV infection, following a prolonged period of viral suppression. The patient had no evidence of cryoglobulinaemia prior to HCV treatment and undetectable HCV RNA levels at the time of presentation with MNM. The case raises the possibility that MNM could develop as an adverse immunomodulatory effect of pegylated interferon therapy

Efficacy of anidulafungin in 539 patients with invasive candidiasis: a patient-level pooled analysis of six clinical trials

Item does not contain fulltextObjectives: To evaluate the efficacy of anidulafungin for the treatment of candidaemia and invasive candidiasis in a large dataset, including patients with deep-seated tissue candidiasis, neutropenia and infection due to non- albicans Candida species. Methods: Data were pooled from six prospective, multicentre, multinational studies: four open-label, non-comparative studies of anidulafungin and two double-blind, double-dummy, randomized studies of anidulafungin versus caspofungin (clinical trial registrations: NCT00496197, NCT00548262, NCT00537329, NCT00689338, NCT00806351 and NCT00805740; ClinicalTrials.gov). In all studies, patients with culture-confirmed invasive candidiasis received a single intravenous (iv) loading dose of anidulafungin 200 mg on day 1, followed by 100 mg once-daily. Switch to oral fluconazole or voriconazole was permitted after 5-10 days of iv treatment in all studies except one. Antifungal treatment (iv plus oral therapy if applicable) was maintained for >/=14 days after the last positive Candida culture. The primary endpoint was successful global response at end of iv therapy (EOivT) in the modified ITT (mITT) population. Results: In total, 539 patients were included (mITT population). The most common baseline Candida species were Candida albicans (47.9%), Candida glabrata (21.0%), Candida tropicalis (13.7%), Candida parapsilosis (13.2%) and Candida krusei (3.5%). Median duration of anidulafungin iv treatment was 10.0 days. The global response success rate at EOivT was 76.4% (95% CI 72.9%-80.0%). All-cause mortality was 13.0% on day 14 and 19.1% on day 28. Adverse events (AEs) were consistent with the known AE profile for anidulafungin. Conclusions: These data demonstrate that anidulafungin is effective for treatment of candidaemia and invasive candidiasis in a broad patient population

On the energy-momentum tensor for a scalar field on manifolds with boundaries

We argue that already at classical level the energy-momentum tensor for a scalar field on manifolds with boundaries in addition to the bulk part contains a contribution located on the boundary. Using the standard variational procedure for the action with the boundary term, the expression for the surface energy-momentum tensor is derived for arbitrary bulk and boundary geometries. Integral conservation laws are investigated. The corresponding conserved charges are constructed and their relation to the proper densities is discussed. Further we study the vacuum expectation value of the energy-momentum tensor in the corresponding quantum field theory. It is shown that the surface term in the energy-momentum tensor is essential to obtain the equality between the vacuum energy, evaluated as the sum of the zero-point energies for each normal mode of frequency, and the energy derived by the integration of the corresponding vacuum energy density. As an application, by using the zeta function technique, we evaluate the surface energy for a quantum scalar field confined inside a spherical shell.Comment: 25 pages, 2 figures, section and appendix on the surface energy for a spherical shell are added, references added, accepted for publication in Phys. Rev.

Culinary tourism and food trends

This article aims to highlight the importance of segmenting and bringing a consensual definition on food tourism, gastronomic tourism and culinary, in the international Academia. We will then focus on culinary tourism as a market trend, also recognizing the food trends, grouped as products in this typology of food tourism. As a way of achieving the proposed objective, we proceeded to select indicators of trends in the area of food tourism, based on a review of the scientific literature. As a result of the literature review, two models are presented, one of the definitions of culinary tourism, based on five components, the other as a model of creation of new touristic food products. Finally, with this review, we wish to contribute to the recognition of more accurate market strategies towards these types of food tourism, impaired with the respect for local and regional heritages of the touristic destinations.info:eu-repo/semantics/publishedVersio

Thiamine increases resident endoglin positive cardiac progenitor cells and atrial contractile force in humans:A randomised controlled trial

Background: The heart has an intrinsic ability to regenerate, orchestrated by progenitor or stem cells. However, the relative complexity of non-resident cardiac progenitor cell (CPC) therapy makes modulation of resident CPCs a more attractive treatment target. Thiamine analogues improve resident CPC function in pre-clinical models. In this double blinded randomised controlled trial (identifier: ACTRN12614000755639), we examined whether thiamine would improve CPC function in humans. Methods and results: High dose oral thiamine (one gram twice daily) or matching placebo was administered 3–5 days prior to coronary artery bypass surgery (CABG). Right atrial appendages were collected at the time of CABG, and CPCs isolated. There was no difference in the primary outcome (proliferation ability of CPCs) between treatment groups. Older age was not associated with decreased proliferation ability. In exploratory analyses, isolated CPCs in the thiamine group showed an increase in the proportion of CD34−/CD105+ (endoglin) cells, but no difference in CD34−/CD90+ or CD34+ cells. Thiamine increased maximum force developed by isolated trabeculae, with no difference in relaxation time or beta-adrenergic responsiveness. Conclusion: Thiamine does not improve proliferation ability of CPC in patients undergoing CABG, but increases the proportion of CD34−/CD105+ cells. Having not met its primary endpoint, this study provides the impetus to re-examine CPC biology prior to any clinical outcome-based trial examining potential beneficial cardiovascular effects of thiamine.</p