Structural Analysis of Steel Structures under Fire Loading

This paper focuses on the structural analysis of a steel structure under fire loading. In this framework, the objective is to highlight the importance of the right choice of analyses to develop, and of the finite element codes able to model the resistance and stiffness reduction due to the temperature increase. In addition, the evaluation of the structural collapse under fire load of a real building is considered, paying attention to the global behavior of the structure itself.

syphilitic chancres of the mouth three cases

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Il pioderma gangrenoso: nuovi aspetti clinici e patogenetici

Il pioderma gangrenoso (PG) \ue8 una rara dermatosi neutrofilica ad evoluzione cronica. Esordisce tipicamente con una o pi\uf9 pustole sterili che, nella presentazione classica della malattia, evolvono rapidamente in ulcere dolenti, di ampiezza e profondit\ue0 variabile, caratterizzate da bordi netti e rilevati di colorito eritemato-violaceo. Varianti di PG meno comuni sono la vegetante e la bollosa. Il PG \ue8 frequentemente associato a patologie sistemiche, in particolare malattie infiammatorie croniche intestinali, affezioni reumatologiche ed ematologiche e neoplasie, ma pu\uf2 presentarsi anche in forma idiopatica. La diagnosi di PG si basa sull\u2019aspetto clinico delle lesioni e sul quadro istopatologico, il quale, seppure non tipico, \ue8 suggestivo. Le terapie pi\uf9 accreditate per il trattamento del PG sono rappresentate dai corticosteroidi sistemici e dalla ciclosporina; tuttavia non sono al momento disponibili linee guida clinico-terapeutiche basate su studi controllati. Negli ultimi quattro anni abbiamo valutato in modo prospettico 20 pazienti (10 donne e 10 uomini) portatori di diverse varianti di PG, con l\u2019obiettivo di proporre una classificazione che metta in relazione il numero delle lesioni cutanee e la percentuale di superficie corporea coinvolta (BSA) con l\u2019approccio terapeutico. Sono stati individuati tre sottogruppi di PG: localizzato (numero di lesioni \uf0b3 1, \uf0a3 3; BSA \uf0a3 5), multilesionale (numero di lesioni > 3, \uf0a3 10; BSA > 5) e disseminato (numero di lesioni > 10; BSA > 25). La ciclosporina sistemica, in monoterapia o in associazione ai corticosteroidi sistemici, si \ue8 dimostrata la terapia pi\uf9 efficace sia nel PG multilesionale che in quello disseminato, mentre il tacrolimus ha dato ottimi risultati nelle forme localizzate. Gli antagonisti del TNF-\u3b1 vanno considerati in casi selezionati di PG resistente alla terapia immunosoppressiva convenzionale. Riteniamo pertanto che tale algoritmo terapeutico possa rivelarsi utile nella pratica clinica, anche se studi controllati dovranno confermarne la validit\ue0. Valutando i risultati di uno studio immunoistochimico da noi condotto, presentiamo infine alcuni aspetti nuovi nella patogenesi del PG

Vegetating nodules following erosions on the oral cavity : a quiz

Acta Derm Venereol 95 © 2015 The Authors. doi: 10.2340/00015555-1936 Journal Compilation © 2015 Acta Dermato-Venereologica. ISSN 0001-5555 A 68-year-old Italian man presented with a 7-month history of multiple erosions on the trunk as well as lips and oral cavity. Before admission to our department, he was treated in another institution with systemic corticosteroids (oral prednisone at the initial dose of 1 mg/kg/day, with progressively tapering dosages for 2 months) and other immunosuppressants, such as azathioprine (1.25 mg/kg/ day for 2 months), intravenous immunoglobulins (one cycle consisting of one infusion of 400 mg/kg/day for 5 consecutive days), and rituximab (one cycle consisting of one infusion of 375 mg/m2/every week for 4 weeks), achieving resolution of the cutaneous manifestations but without control of the oral involvement. Upon admission, he had multiple lip and oral erosions (Fig. 1a). In the following days, he developed erythematous-violaceous vegetating nodules that coalesced into ulcerated plaques on the lips and tongue (Fig. 1b). The patient's general condition was compromised; he was asthenic and, due to dysphagia, had lost about 15 kg in the last 3 months. Staging fibroscopy revealed nodules that induced marked stenosis of the larynx and pharynx (Fig. 1c). Within a few days, an emergency tracheotomy was required because of acute dyspnea. Biopsy specimens from a nodule were submitted for histology (Fig. 1d)

Azithromycin SR versus minocycline in the treatment of moderate to severe acne: a phase III, multicentre, randomized, non-inferiority trial

Introduction: The primary objective of this phase III, multicentre, randomized trial was to evaluate whether azithromycin SR (azithromycin microspheres, powder for oral suspension) was non-inferior to oral minocycline in the treatment of moderate to severe acne. The primary efficacy endpoint was the change from baseline in the GAGS score. Secondary endpoints included changes from baseline in the Leeds score and quality of life (QoL). Methods: A total of 118 patients were randomized (1:1) to receive azithromycin SR (2 g/week) (n = 58) or minocycline (100 mg q.d.) (n = 60) for eight weeks. Results: The change from baseline to end of treatment in GAGS score did not differ significantly between the azithromycin SR and minocycline groups [least squares mean -8.69 (95% confidence interval [CI]: -10.33 to -7.05) and -9.16 (95% CI: -10.62 to -7.71), respectively], consistent with the noninferiority of azithromycin SR to minocycline. The lower limit of 95% confidence interval of the change from baseline to end of treatment in GAGS scores between the 2 groups (95% CI: -2.48 to 1.54) did not exceed the pre-defined non-inferiority margin of -3. In addition, there were no significant differences in improvement of acne graded by the Leeds score and QoL. Twenty-six patients (44.8%) in the azithromycin SR group and 9 patients (15%) in the minocycline group reported gastro-intestinal disorders. Conclusions: In patients with moderate to severe acne, azithromycin SR is non-inferior to minocycline for primary endpoint (GAGS score), with no significant differences in secondary endpoints