Rectal budesonide and mesalamine formulations in active ulcerative proctosigmoiditis: efficacy, tolerance, and treatment approach

Ulcerative colitis (UC) is an immune-mediated disease of the colon that is characterized by diffuse and continuous inflammation contiguous from the rectum. Half of UC patients have inflammation limited to the distal colon (proctitis or proctosigmoiditis) that primarily causes symptoms of bloody diarrhea and urgency. Mild-to-moderate distal UC can be effectively treated with topical formulations (rectal suppositories, enemas, or foam) of mesalamine or steroids to reduce mucosal inflammation and alleviate symptoms. Enemas or foam formulations adequately reach up to the splenic flexure, have a minimal side-effect profile, and induce remission alone or in combination with systemic immunosuppressive therapy. Herein, we compare the efficacy, cost, patient tolerance, and side-effect profiles of steroid and mesalamine rectal formulations in distal UC. Patients with distal mild-to-moderate UC have a remission rate of approximately 75% (NNT =2) after treatment for 6 weeks with mesalamine enemas. Rectal budesonide foam induces remission in 41.2% of patients with mild-to-moderate active distal UC compared to 24% of patient treated with placebo (NNT =5). However, rectal budesonide has better patient tolerance profile compared to enema formulations. Despite its favorable efficacy, safety, and cost profiles, patients and physicians significantly underuse topical treatments for treating distal colitis. This necessitates improved patient education and physician familiarity regarding the indications, effectiveness, and potential financial and tolerability barriers in using rectal formulations

Sindrome di charge: risultati a lungo termine della riabilitazione audiologica

Obiettivo del presente lavoro è valutare i risultati della riabilitazione audiologica su un gruppo, numericamente consistente, di bambini affetti da sindrome di CHARGE. Lo studio è stato eseguito retrospettivamente, utilizzando il database dei pazienti pediatrici, presso l’Audiologia dell’Azienda Ospedaliero-Universitaria di Padova e di Ferrara. Sono stati individuati 31 bambini in totale, che hanno presentato diversi gradi di disabilità uditiva associata alla sindrome di CHARGE. La valutazione audiologica è stata eseguita utilizzando i potenziali evocati uditivi (ABR) e/o l’elettrococleografia, oppure le tecniche di audiometria infantile (VRA o play audiometry). Sono stati valutati anche i risultati percettivi, in termini di capacità di comunicazione e linguaggio espressivo. Sono quindi stati studiati gli effetti della riabilitazione uditiva (con apparecchio acustico o impianto cocleare) e in particolare lo sviluppo del linguaggio nel corso di un lungo follow-up. Gli esiti degli interventi riabilitativi sono risultati diversi in relazione alle eterogenee e spesso gravi disabilità associate alla sindrome di CHARGE (ad esempio, ritardo di sviluppo psico-fisico, gravi disturbi visivi concomitanti, disfunzioni uditive retrococleari per neuropatia uditiva/dissincronia associata). Anche dopo lungo follow-up, lo sviluppo del linguaggio è risultato gravemente compromesso nella maggior parte dei casi, suggerendo quindi la necessità di sviluppare modalità di comunicazione alternative in questo gruppo di piccoli Pazienti. L’identificazione precoce della sordità neurosensoriale e l’accurata pianificazione di trattamenti riabilitativi mirati, è in ogni caso fondamentale nei bambini con sindrome di CHARGE

Field emission properties of carbon nanotube arrays grown in porous anodic alumina

AbstractCarbon nanotubes (CNTs), with their excellent electronic properties and extremely high aspect ratio, represent an ideal material for building electron sources based on field emission. Fowler‐Nordheim equation describes quite successfully the field emission phenomenon, especially for single or isolated tips. However, some complications arise when populations of CNTs are considered, where collective effects and large variability in the emitters features influence the measured I–V characteristics. In this work, the emission properties of multi‐walled CNTs grown within ordered anodic alumina templates are investigated. These CNT matrices produce current densities up to some tens of mA/cm2, and the field enhancement factor for collective emission sources can be estimated. Such material can be modelled as an ordered and uniform array of emitters and a simulation of the electrostatic field on the emission tips can be done in order to evaluate the field enhancement factor and its dependence on various geometries. This allows comparing predictions from simulation and experimental measurements, in a direct way. (© 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim

Human papillomavirus 9-valent vaccine for cancer prevention: a systematic review of the available evidence.

In 2014, the Food and Drug Administration approved a new human papillomavirus 9-valent vaccine (9vHPV), targeting nine HPV types: HPV types 6, 11, 16, and 18, which are also targeted by the quadrivalent HPV vaccine (qHPV), plus five additional high cancer risk HPV types (HPV types 31, 33, 45, 52, and 58). The aim of the current study was to systematically retrieve, qualitatively and quantitatively pool, as well as critically appraise all available evidence on 9vHPV from randomized controlled trials (RCTs). We conducted a systematic review of the literature on 9vHPV efficacy, immunogenicity and safety, as well as a systematic search of registered, completed, and ongoing RCTs. We retrieved and screened 227 records for eligibility. A total of 10 publications reported on RCTs' results on 9vHPV and were included in the review. Sixteen RCTs on 9vHPV have been registered on RCT registries. There is evidence that 9vHPV generated a response to HPV types 6, 11, 16 and 18 that was non-inferior to qHPV. Vaccine efficacy against five additional HPV type-related diseases was directly assessed on females aged 16-26 years (risk reduction against high-grade cervical, vulvar or vaginal disease = 96·7%, 95% CI 80·9%-99·8%). Bridging efficacy was demonstrated for males and females aged 9-15 years and males aged 16-26 years (the lower bound of the 95% CIs of both the geometric mean titer ratio and difference in seroconversion rates meeting the criteria for non-inferiority for all HPV types). Overall, 9vHPV has been proved to be safe and well tolerated. Other RCTs addressed: 9vHPV co-administration with other vaccines, 9vHPV administration in subjects that previously received qHPV and 9vHPV efficacy in regimens containing fewer than three doses. The inclusion of additional HPV types in 9vHPV offers great potential to expand protection against HPV infection. However, the impact of 9vHPV on reducing the global burden of HPV-related disease will greatly depend on vaccine uptake, coverage, availability, and affordability

Corticosteroids increase the risk of invasive fungal infections more than tumor necrosis factor-alpha inhibitors in patients with inflammatory bowel disease

BACKGROUND: Invasive fungal infections are a devastating complication of inflammatory bowel disease (IBD) treatment. We aimed to determine the incidence of fungal infections in IBD patients and examine the risk with tumor necrosis factor-alpha inhibitors (anti-TNF) compared with corticosteroids. METHODS: In a retrospective cohort study using the IBM MarketScan Commercial Database we identified US patients with IBD and at least 6 months enrollment from 2006 to 2018. The primary outcome was a composite of invasive fungal infections, identified by ICD-9/10-CM codes plus antifungal treatment. Tuberculosis (TB) infections were a secondary outcome, with infections presented as cases/100 000 person-years (PY). A proportional hazards model was used to determine the association of IBD medications (as time-dependent variables) and invasive fungal infections, controlling for comorbidities and IBD severity. RESULTS: Among 652 920 patients with IBD, the rate of invasive fungal infections was 47.9 cases per 100 000 PY (95% CI 44.7-51.4), which was more than double the TB rate (22 cases [CI 20-24], per 100 000 PY). Histoplasmosis was the most common invasive fungal infection (12.0 cases [CI 10.4-13.8] per 100 000 PY). After controlling for comorbidities and IBD severity, corticosteroids (hazard ratio [HR] 5.4; CI 4.6-6.2) and anti-TNFs (HR 1.6; CI 1.3-2.1) were associated with invasive fungal infections. CONCLUSIONS: Invasive fungal infections are more common than TB in patients with IBD. The risk of invasive fungal infections with corticosteroids is more than double that of anti-TNFs. Minimizing corticosteroid use in IBD patients may decrease the risk of fungal infections

Characterization of the paracrine effects of human skeletal myoblasts transplanted in infarcted myocardium

The discrepancy between the functional improvements yielded experimentally by skeletal myoblasts (SM) transplanted in infarcted myocardium and the paucity of their long-term engraftment has raised the hypothesis of cell-mediated paracrine mechanisms. Methods and results: We analyzed gene expression and growth factors released by undifferentiated human SM (CD56+), myotubes (SM cultured until confluence) and fibroblasts-like cells (CD56−). Gene expression revealed up-regulation of pro-angiogenic (PGF), antiapoptotics (BAG-1, BCL-2), heart development (TNNT2, TNNC1) and extracellular matrix remodelling (MMP-2, MMP-7) genes in SM. In line with the gene expression profile, the analysis of culture supernatants of SM by ELISA identified the release of growth factors involved in angiogenesis (VEGF, PIGF, angiogenin, angiopoietin, HGF and PDGF-BB) as well as proteases involved in matrix remodelling (MMP2, MMP9 and MMP10) and their inhibitors (TIMPs). Culture of smooth muscle cells (SMC), cardiomyocytes (HL-1) and human umbilical vein endothelial cells (HUVECs) with SM-released conditioned media demonstrated an increased proliferation of HUVEC, SMC and cardiomyocytes (pb0.05) and a decrease in apoptosis of cardiomyocytes (pb0.05). Analysis of nude rats transplanted with human SM demonstrated expression of human-specific MMP-2, TNNI3, CNN3, PGF, TNNT2, PAX7, TGF-β, and IGF-1 1 month after transplant. Conclusions: Our data support the paracrine hypothesis whereby myoblast-secreted factors may contribute to the beneficial effects of myogenic cell transplantation in infarcted myocardium. © 2008 European Society of Cardiology. Published by Elsevie

A prototype model for evaluating SKA-LOW station calibration

The Square Kilometre Array telescope at low-frequency (SKA-Low) will be a phased array telescope supporting a wide range of science cases covering the frequency band 50 - 350 MHz, while at the same time asking for high sensitivity and excellent characteristics. These extremely challenging requirements resulted in a design using 512 groups of 256 log periodic dual polarized antennas each (where each group is called “station”), for a total of 131072 antennas. The 512 stations are randomly distributed mostly within a dense area around the centre of the SKA-Low, and then in 3 arms having 16 station clusters each. In preparation for the SKA Phase 1 (SKA1) System Critical Design Review (CDR), prototype stations were deployed at the Murchison Radio-astronomy Observatory (MRO) site (Western Australia) near the Murchison Widefield Array (MWA) radio telescope. The project involved multiple parties in an International collaboration building and testing different prototypes of the SKA1-Low station near the actual site. This resulted in both organisational and logistic challenges typical of a deployment of the actual telescope. The test set-up involved a phased build-up of the complex station of log-periodic antennas, by starting from the deployment of 48 antennas and related station signal processing (called AAVS1.5, where AAVS stands for Aperture Array Verification System), followed by expansion to a full station (AAVS2.0). As reference a station with dipole antennas EDA2 (EDA: Engineering Development Array) was deployed. This test set-up was used for an extensive test and evaluation programme. All test antenna configurations were simulated in detail by electromagnetic (EM) models, and the prediction of the models was further verified by appropriate tests with a drone-based radio frequency source. Astronomical observations on Sun and galaxy transit were performed with calibrated stations of both EDA2, AAVS1.5 and AAVS2.0. All 3 configurations were calibrated. EM modelling and calibration results for the full station AAVS2.0 and EM verification for the AAVS1.5 station are presented. The comparisons between the behaviour of the log-periodic antennas and the dipoles have advanced our understanding the calibration quality and the technological maturity of the future SKA1-Low array

Clinical Practice: Giant Cell Tumour of the Jaw Mimicking Bone Malignancy on Three-Dimensional Computed Tomography (3D CT) Reconstruction

A wide range of diseases may present with radiographic features of osteolysis. Periapical inflammation, cysts and benign tumours, bone malignancies, all of these conditions may show bone resorption on radiograph. Features of the surrounding bone, margins of the lesion, and biological behaviour including tendency to infiltration and root resorption, may represent important criteria for distinguishing benign tumours from their malign counterpart, although the radiographic aspect of the lesion is not always predictive. Therefore a critical differential diagnosis has to be reached to choose the best management. Here, we report a case of giant cell tumour (GCT) whose radiological features by computed tomography (CT) suggested the presence of bone malignancy, whereas the evaluation of a routine OPT scan comforted us about the benign nature of the lesion. A brief review of the literature on such a benign but locally aggressive neoplasm is also provided

Clinical Practice: Giant Cell Tumour of the Jaw Mimicking Bone Malignancy on Three-Dimensional Computed Tomography (3D CT) Reconstruction

A wide range of diseases may present with radiographic features of osteolysis. Periapical inflammation, cysts and benign tumours, bone malignancies, all of these conditions may show bone resorption on radiograph. Features of the surrounding bone, margins of the lesion, and biological behaviour including tendency to infiltration and root resorption, may represent important criteria for distinguishing benign tumours from their malign counterpart, although the radiographic aspect of the lesion is not always predictive. Therefore a critical differential diagnosis has to be reached to choose the best management. Here, we report a case of giant cell tumour (GCT) whose radiological features by computed tomography (CT) suggested the presence of bone malignancy, whereas the evaluation of a routine OPT scan comforted us about the benign nature of the lesion. A brief review of the literature on such a benign but locally aggressive neoplasm is also provided