Endogenous glutamine decrease is associated with pancreatic cancer progression

Abstract Pancreatic ductal adenocarcinoma (PDAC) is becoming the second leading cause of cancer-related death in the Western world. The mortality is very high, which emphasizes the need to identify biomarkers for early detection. As glutamine metabolism alteration is a feature of PDAC, its in vivo evaluation may provide a useful tool for biomarker identification. Our aim was to identify a handy method to evaluate blood glutamine consumption in mouse models of PDAC. We quantified the in vitro glutamine uptake by Mass Spectrometry (MS) in tumor cell supernatants and showed that it was higher in PDAC compared to non-PDAC tumor and pancreatic control human cells. The increased glutamine uptake was paralleled by higher activity of most glutamine pathway-related enzymes supporting nucleotide and ATP production. Free glutamine blood levels were evaluated in orthotopic and \u202

Diagnosis of pulmonary tuberculosis in children and adolescents: comparison of two versions of the Brazilian Ministry of Health scoring system

The aim of this study was to evaluate the concordance between two versions of the scoring system (2011 and 2019), recommended by the Brazilian Ministry of Health, for the diagnosis of pulmonary tuberculosis (PTB) in children and adolescents. A retrospective descriptive study was performed to assess the medical records of children and adolescents with PTB, in TB units from Brazilian cities located in Rio de Janeiro, Minas Gerais, and Parana States, from January 1st, 2004, to December 1st, 2018. Patients aged 0 to 18 years old with a diagnosis of PTB were included. The comparison between the two scoring systems showed a moderate concordance according to the κ coefficient value = 0.625. Fourteen patients showed a reduction in the TB score, going from 30 points in the 2011, to 25 points or less in the 2019 one. Seventy one percent of these 14 patients had radiological changes suggestive of PTB and 86% had tuberculin skin tests greater than 10 mm. The study concluded that a moderate agreement was observed between the 2011 and 2019 scoring systems, with an increase in the number of patients scoring 25 points or less in 2019, which can eventually hinder the diagnosis of PTB

A concept for integrated care pathways for atopic dermatitis-A GA2^{2} LEN ADCARE initiative

Introduction: The integrated care pathways for atopic dermatitis (AD‐ICPs) aim to bridge the gap between existing AD treatment evidence‐based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co‐ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. Methods: The GA$^{2}$LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD‐ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL$^{2}$EN ADCARE centres. Results: The AD‐ICPs outline the diagnostic procedures, possible co‐morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. Conclusion: The AD‐ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Cement-Based Mortars with Waste Paper Sludge-Derived Cellulose Fibers for Building Applications

This study assesses the mechanical properties of mortars incorporating waste paper sludge-derived cellulose fibers. Compression and flexural tests were carried out on specimens prepared with cellulose fibers at different proportions, ranging from 0% to 2% of the total weight of the solid mortar constituents (cement, sand, and lime). In addition, a comparative analysis was carried out to evaluate the influence of the preparation method on the mechanical properties of the mortars. To this end, two series of mortars were studied: one prepared following a rigorous control of the preparation parameters and the other made without systematic parameter control to simulate typical on-site conditions. Finally, the applicability of both traditional and eco-friendly mortars in the construction of small-scale masonry walls was assessed through compression tests. Overall, the mechanical properties of mortars with cellulose fibers were comparable to those with 0% waste material, regardless of the production process. Regarding the compressive behavior of masonry walls, experimental tests showed significant similarities between specimens made with traditional and eco-friendly mortar. In conclusion, incorporating cellulose fibers into cement-based mortar shows considerable potential for building applications, enhancing the environmental benefits without compromising the mechanical behavior

Dialectical behaviour therapy (DBT) for forensic psychiatric patients: An Italian pilot study

Background: Several previous randomised controlled trials of dialectical behaviour therapy (DBT) since Linehan's original have shown that it has an advantage over standard care or other psychological treatments, but focus is usually on suicide-related behaviours, and little is known about its effect with offender-patients. Aims: To evaluate DBT with a group of offender-patients in the Italian high intensity therapeutic facilities—the Residenze per l'Esecuzione delle Misure di Sicurezza (REMS), established under the Italian Law 81/2014. Methods: Twenty-one male forensic psychiatric in-patients with borderline personality disorder were enrolled and randomly assigned to 12 months of standard DBT together with all the usual REMS treatments (n = 10) or usual REMS treatments alone (n = 11). All participants completed the same pretreatment and posttreatment assessments, including the Barratt Impulsiveness Scale (BIS-11), Difficulties in Emotion Regulation Scale (DERS), and Toronto Alexithymia Scale 20 (TAS-20). Results: Men receiving DBT showed a significantly greater reduction in motor impulsiveness, as measured by the BIS-11, and emotional regulation, as reflected by the DERS total score, than the controls. There were no significant differences between groups in alexithymia scores. Conclusions: Italy has innovative forensic psychiatric facilities with a new recovery–rehabilitation approach, but the ambitious goals behind these cannot be achieved by pharmacology alone. For the first time in clinical forensic settings in Italy, there has been limited access to DBT. This small pilot study suggests this is likely to help ameliorate traits associated with violent and antisocial behaviours, so a full-scale randomised controlled trial should follow

An approach about Intrauterine Device as an emergency contraception method.

Esse trabalho objetiva avaliar a utiliza??o e a efic?cia do Dispositivo Intrauterino (DIU) como m?todo contraceptivo de emerg?ncia. Trata-se de trabalho de revis?o liter?ria realizado a partir de pesquisa na base de dados Biblioteca Virtual em Sa?de (BVS), PubMed e SciELO entre fevereiro e junho de 2015. Foram inclu?dos artigos obtidos do ano 2004 at? 2015 em ingl?s, espanhol e portugu?s de revis?o sistem?tica, revis?o de literatura e estudos observacionais. Existe elevada efic?cia do DIU como contraceptivo de emerg?ncia at? mesmo quando comparado ? p?lula do dia seguinte. Ap?s 72 horas do coito na aus?ncia de prote??o, o dispositivo ? a melhor alternativa de emerg?ncia para evitar gravidez. A doen?a inflamat?ria p?lvica (DIP) ? abordada como poss?vel efeito colateral da inser??o do DIU, entretanto os ?ndices de ocorr?ncia s?o extremamente baixos. O DIU ? um m?todo eficaz para anticoncep??o de emerg?ncia.This study evaluates the use and efficacy of the Intrauterine Device (IUD) as an emergency contraceptive. Consists of a literature review from research done in the database of Biblioteca Virtual em Sa?de (BVS), PubMed and SciELO between February and June 2015. The chosen articles consisted of systematic review, literature review and observational study, all published from 2004 to 2015 in English, Spanish and Portuguese. The Intrauterine Device (IUD) is highly effective as an emergency contraceptive even when compared to the morning-after pill. After 72 hours of unprotected intercourse, the IUD is the best emergency alternative to avoid pregnancy. Pelvic inflammatory disease (PID) is discussed as a possible side effect of IUD insertion however the occurrence rates are extremely low. The IUD is an effective method of emergency contraception