Clinical-evolutional particularities of the cryoglobulinemic vasculitis in the case of a patient diagnosed with hepatitis C virus in the predialitic phase

Hepatitis C virus (HCV) represents a fundamental issue for public health, with long term evolution and the gradual appearance of several complications and associated pathologies. One of these pathologies is represented by cryoglobulinemic vasculitis, a disorder characterized by the appearance in the patient’s serum of the cryoglobulins, which typically precipitate at temperatures below normal body temperature (37°C) and dissolve again if the serum is heated. Here, we describe the case of a patient diagnosed with HCV that, during the evolution of the hepatic disease, developed a form of cryoglobulinemic vasculitis. The connection between the vasculitis and the hepatic disorder was revealed following treatment with interferon, with the temporary remission of both pathologies and subsequent relapse at the end of the 12 months of treatment, the patient becoming a non-responder. The particularity of the case is represented by both the severity of the vasculitic disease from its onset and the deterioration of renal function up to the predialitic phase, a situation not typical of the evolution of cryoglobulinemia. Taking into account the hepatic disorder, the inevitable evolution towards cirrhosis, and the risk of developing the hepatocellular carcinoma, close monitoring is necessary

Triple valve infective endocarditis - a late diagnosis

Behcet\u27s disease is a systemic vasculitis of unknown aetiology with cardiac involvement as well as damage to other organs. Whether the sterile valvular inflammation which occurs in this autoimmune disease predisposes to bacterial adhesion and infective endocarditis is not yet established. We present the case of a patient with Behcet disease in which transthoracic echocardiography showed mobile masses on the aortic, tricuspid, and mitral valves, leading to multivalvular infective endocarditis diagnosis, possibly in the context of valvular inflammation. The case presented in this article confirms observation of other studies, namely that ultrasonography plays an important role in the diagnosis and evaluation of rheumatic diseases and permits optimal management in daily practice

Modern methods of endovascular approach to cerebral arteriovenous malformations

The article is a review of major historical events in the development of the methods of endovascular approach of arteriovenous malformations (AVM) starting with the first cerebral angiography performed on a dog in 1926, Serbinenko’s embolization techniques of cerebral vascular lesions using detachable balloons in 1974, ending with January 1991 when the first embolization with GDC (Guglielmi detachable coils) was done on a brain aneurysm. It’s considered that there are approximately 1,100 patients diagnosed with cerebral arteriovenous malformation treated with GDC each month

Microsurgical Approach in a Thoracic Meningioma in Elderly: Case Report

Improved results in the treatment of intraspinal tumors have followed greater sophistication of diagnostic modalities and surgical techniques. Whereas originally tumors could be diagnosed radiologically only by bone erosion seen on radiographic films, now mielography, computed tomography (CT) and magnetic resonance imaging (MRI) provide precise localization. Indeed, MRI is a stand-alone diagnostic preoperative study for virtually all intradural tumors. With the advent of the operating microscope, microsurgical instruments, bipolar cautery and intraoperative ultrasonography, combined with ultrasoniccavitation devices and other techniques, surgeons can approach these tumors with greater ease

Deformation behaviour of TiN and Ti–Al–N coatings at 295 to 573 K

Temperature-dependent nanoindentation testing was employed to investigate the deformation behaviour of magnetron sputtered (100) TiN and Ti1-xAlxN (x = 0.34, 0.52, 0.62) coatings in the temperature range from 295 to 573 K. The maximum temperature is sufficiently below the deposition temperature of 773 K to guarantee for stable microstructure and stress state during testing. The TiN coating displayed the same hardness as bulk single crystal (SC) TiNbulk. The addition of aluminium to TiN (to form single-phase face centred cubic structured Ti1-xAlxN coatings) increased the room temperature hardness due to increased bond strength, lattice strain and higher activation energy for the dislocation slip. For coatings with a low aluminium content, Ti0.66Al0.34N, the decrease in hardness with temperature was similar to the TiN coating and SC-TiNbulk. In contrast, the hardness of coatings with moderate, Ti0.48Al0.52N, and high, Ti0.38Al0.62N, aluminium contents varied little up to 573 K. Thus, the Ti1-xAlxN matrix is mechanically more stable at elevated temperatures than its TiN relative, by providing a lower decrease in lattice resistance to the dislocation flow with increasing temperature. The findings suggest that the addition of Al to TiN (to form Ti1-xAlxN solid solutions) not only improves the hardness but also leads to stable hardness with temperature, and emphasizes the importance of bonding states and chemical fluctuations, next to structure and morphology of the coatings that develop with changing the chemistry

Role of synovial fibroblast subsets across synovial pathotypes in rheumatoid arthritis: a deconvolution analysis

OBJECTIVES: To integrate published single-cell RNA sequencing (scRNA-seq) data and assess the contribution of synovial fibroblast (SF) subsets to synovial pathotypes and respective clinical characteristics in treatment-naïve early arthritis. METHODS: In this in silico study, we integrated scRNA-seq data from published studies with additional unpublished in-house data. Standard Seurat, Harmony and Liger workflow was performed for integration and differential gene expression analysis. We estimated single cell type proportions in bulk RNA-seq data (deconvolution) from synovial tissue from 87 treatment-naïve early arthritis patients in the Pathobiology of Early Arthritis Cohort using MuSiC. SF proportions across synovial pathotypes (fibroid, lymphoid and myeloid) and relationship of disease activity measurements across different synovial pathotypes were assessed. RESULTS: We identified four SF clusters with respective marker genes: PRG4(+) SF (CD55, MMP3, PRG4, THY1(neg)); CXCL12(+) SF (CXCL12, CCL2, ADAMTS1, THY1(low)); POSTN(+) SF (POSTN, collagen genes, THY1); CXCL14(+) SF (CXCL14, C3, CD34, ASPN, THY1) that correspond to lining (PRG4(+) SF) and sublining (CXCL12(+) SF, POSTN(+) + and CXCL14(+) SF) SF subsets. CXCL12(+) SF and POSTN(+) + were most prominent in the fibroid while PRG4(+) SF appeared highest in the myeloid pathotype. Corresponding, lining assessed by histology (assessed by Krenn-Score) was thicker in the myeloid, but also in the lymphoid pathotype + the fibroid pathotype. PRG4(+) SF correlated positively with disease severity parameters in the fibroid, POSTN(+) SF in the lymphoid pathotype whereas CXCL14(+) SF showed negative association with disease severity in all pathotypes. CONCLUSION: This study shows a so far unexplored association between distinct synovial pathologies and SF subtypes defined by scRNA-seq. The knowledge of the diverse interplay of SF with immune cells will advance opportunities for tailored targeted treatments