Atrial flutter regression in HIV-associated pulmonary arterial hypertension after treatment with bosentan

Pulmonary arterial hypertension (PAH) is a rare condition characterized by an increase in pulmonary arterial resistance leading to right heart failure and death. Arrhythmias are a growing problem in PAH; therefore, maintenance of sinus rhythm is considered to be an important treatment aim in these patients. We described the case of a 46-year-old woman with HIV-associated pulmonary arterial hypertension who developed atrial flutter. After treatment with bosentan, it was observed a significant improvement in clinical and haemodynamic parameters. In addition, the AFL, which had previously persisted to both antiarrhythmic drug therapy and electrical stimulation, and had recurred after transthoracic electrical cardioversion, disappeared in absence of any antiarrhythmic drug. Though the precise factors responsible for supraventricular arrhythmogenesis are still largely obscure, it is likely that initiation and maintenance of AFL may depend on all the conditions that can lead to increase in right atrial pressure, size, and wall stress, such as PAH. In our case, bosentan reduced both mean pulmonary artery pressure (mPAP) value and right heart chambers pressures. Therefore, it is conceivable that with the anatomical substrate needed for the maintenance of AFL being disappeared, sinus rhythm was restored.</p

The Chandra Cygnus OB2 Legacy Survey: Design and X-Ray Point-source Catalog

© 2023, The Author(s). Published by the American Astronomical Society. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/The Cygnus OB2 association is the largest concentration of young and massive stars within 2 kpc of the Sun, including an estimated ∼65 O-type stars and hundreds of OB stars. The Chandra Cygnus OB2 Legacy Survey is a large imaging program undertaken with the Advanced CCD Imaging Spectrometer on board the Chandra X-ray Observatory. The survey has imaged the central 0.5 deg2 of the Cyg OB2 association with an effective exposure of ∼120 ks and an outer 0.35 deg2 area with an exposure of ∼60 ks. Here we describe the survey design and observations, discuss the data reduction and source detection, and present a catalog of ∼8000 X-ray point sources. The survey design employs a grid of 36 heavily (∼50%) overlapping pointings, a method that overcomes Chandra's low off-axis sensitivity and produces a highly uniform exposure over the inner 0.5 deg2. The full X-ray catalog is described here and is made available online.Peer reviewe

NUTRITION, MALNUTRITION AND DIETARY INTERVENTIONS IN INFLAMMATORY BOWEL DISEASE

Inflammatory Bowel Disease (IBD), which includes both Crohn's disease (CD) and Ulcerative Colitis (UC), is a chronic idiopathic inflammatory disorder affecting the gastrointestinal tract. Diet, as a source of luminal antigens, is thought to be an important factor in the pathogenesis of IBD. often the nutritional status of patients is significantly compromised, particularly in CD. several factors, including drug-nutrient interactions, disease location, symptoms, and dietary restriction can lead to protein energy malnutrition and specific nutritional deficiencies. solid evidence regarding the accountability of certain dietary components in the etiology of IBD are lacking. With regard to malnutrition, its consequence are growth failure, weight loss, bone disease, and/or micronutrient deficiencies, although micronutrient deficiency in IBD in most cases does not tend to have any evident clinical manifestation, except with regardo of iron, folic acid, and vitamin B. Nutritional supplemantation is essential for patients with evidence of malnutrition to increase calorie, and protein intake. Nutritional supplementation can also have efficacy in the induction and maintenance of remission in adults with CD, however it does not replace other treatments. Aim of this review is to discuss the role of nutrition and nutrients' deficiencies in the clinical setting of IBD, and to analyze efficacy and safety of the dietary interventions in patients with IBD

Classification of Chandra X-Ray Sources in Cygnus OB2

© 2023. The Author(s). Published by the American Astronomical Society. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/We have devised a predominantly Naive Bayes−based method to classify X-ray sources detected by Chandra in the Cygnus OB2 association into members, foreground objects, and background objects. We employ a variety of X-ray, optical, and infrared characteristics to construct likelihoods using training sets defined by well-measured sources. Combinations of optical photometry from the Sloan Digital Sky Survey (riz) and Isaac Newton Telescope Photometric Hα Survey (r I i I Hα), infrared magnitudes from United Kingdom Infrared Telescope Deep Sky Survey and Two-Micron All Sky Survey (JHK), X-ray quantiles and hardness ratios, and estimates of extinction A v are used to compute the relative probabilities that a given source belongs to one of the classes. Principal component analysis is used to isolate the best axes for separating the classes for the photometric data, and Gaussian component separation is used for X-ray hardness and extinction. Errors in the measurements are accounted for by modeling as Gaussians and integrating over likelihoods approximated as quartic polynomials. We evaluate the accuracy of the classification by inspection and reclassify a number of sources based on infrared magnitudes, the presence of disks, and spectral hardness induced by flaring. We also consider systematic errors due to extinction. Of the 7924 X-ray detections, 5501 have a total of 5597 optical/infrared matches, including 78 with multiple counterparts. We find that ≈6100 objects are likely association members, ≈1400 are background objects, and ≈500 are foreground objects, with an accuracy of 96%, 93%, and 80%, respectively, with an overall classification accuracy of approximately 95%.Peer reviewe

Age spread and sequential star formation in the young cluster NGC 2264

We investigate the structure and star formation history of the NGC 2264 cluster (3 Myr). We combine spectroscopic T_eff with multi-color photometry to derive homogeneous extinction and stellar parameters for 655 cluster members (M_star = 0.2-1.8 M_☉). We infer an intrinsic age spread of ∼4 Myr across the cluster. NGC 2264 members were born in the course of sequential star formation activity, which still continues in the most embedded regions of the cluster. We find evidence for photoevaporation effects driven by OB stars in the region that locally impact the timescales for disk evolution within the cluster

Real-life effectiveness of tildrakizumab in chronic plaque psoriasis: A 52-week multicentre retrospective study—IL PSO (Italian landscape psoriasis)

Background: Tildrakizumab is a humanized monoclonal antibody that binds selectively the p19 subunit of interleukin-23. It is approved for treatment of moderate– severe chronic plaque psoriasis. Objectives: We conducted a 52-week retrospective study to assess the effectiveness and safety of tildrakizumab in a real-life setting. Methods: Our retrospective study included 237 consecutive adults with moderateto-severe plaque psoriasis, enrolled in 10 different Italian centres, treated with tildrakizumab up to Week 52. Patient characteristics, comorbidities, previous treatmentsand the PASI (Psoriasis Area and Severity Index) score at each visit (baseline, Week 16, Week 28 and Week 52) were retrieved from the electronic medical records. The percentages of patients achieving 75%, 90% and 100% (PASI 75, PASI 90 and PASI 100) improvement in PASI with respect to baseline PASI were registered. Results: At Week 52, 90.91%, 73.55% and 58.68% of patients achieved a PASI reduction ≥75% (PASI 75), PASI 90 and PASI 100, respectively. An absolute PASI≤2 was reached by 85.95% at Week 52. Compared with Phase 3 clinical trials, we observed similar rates of PASI 75/90 responses and higher percentages of patients achieving PASI 100. Patients who had not responded to previous biologic treatments and patients with cardio-metabolic comorbidities were significantly more likely to achieve PASI 100 at Week 28 and PASI 90 at Week 52. The higher body mass index did not interfere with the odds of reaching PASI 75/90/100 at each time point. No significant safety findings were recorded throughout the study, and none of the patients had to interrupt the treatment because of adverse events. Conclusion: Our data suggest that the efficacy of tildrakizumab for plaque psoriasis in ‘real-life’ clinical practice is comparable with Phase 3 clinical trials with higher percentages of patients achieving complete skin clearance (PASI 100) at Weeks 16, 28 and 52

Effectiveness, Tolerability, and Drug Survival of Risankizumab in a Real-World Setting: A Three-Year Retrospective Multicenter Study—IL PSO (ITALIAN LANDSCAPE PSORIASIS)

Background: Risankizumab is a humanized monoclonal antibody that selectively inhibits interleukin-23. It has been approved for moderate-to-severe plaque psoriasis and has shown efficacy and safety in clinical trials and real-world experiences. This study aimed to evaluate the long-term effectiveness, safety, and drug survival of risankizumab in a real-life setting. Materials and Methods: We included patients treated with risankizumab from January 2019 to February 2023. A Psoriasis Area and Severity Index score (PASI) was collected at weeks 0, 16, 28, 52, 104, and 156, when available. The occurrence of any adverse events was recorded at each visit. Results: We enrolled 1047 patients. At week 52, a ≥90% improvement in PASI was observed in 81.44% of patients, with a continuous improvement throughout the study (88.99% and 99.07% at weeks 104 and 156, respectively). After three years of treatment, all patients involving the scalp, palms/soles, and genitalia and 95% of patients with nail psoriasis achieved a complete or almost complete skin clearance. No significant safety findings were observed, and 90.73% of the patients were still on treatment after 36 months. Conclusions: This study supports the long-term effectiveness and safety of risankizumab in a real- world setting, even in patients involving difficult-to-treat areas