Tratamiento de la artropatía crónica hemofílica mediante inyecciones intraarticulares de cortisona

Se evaluaron las historias clínicas de 34 pacientes hemofílicos con artropatía crónica severa (25 grado III y 9 grado IV), todos ellos con deformidades axiales, atrofia muscular y limitación del movimiento articular (31 rodillas, 2 tobillos y 2 hombros), a quienes se les inyectó intraarticularmcnte entre 1 y 9 dosis de cortisona de liberación prolongada con intervalos de 3 semanas. Se les realizó una evaluación subjetiva y objetiva en base a los siguientes parámetros: bueno: no dolor, incremento en los rangos de movimiento y total integración a las actividades de la vida diaria; regular: disminución del dolor, igual rango de movilidad y actividades de la vida diaria limitadas, y malo: persistencia del dolor, disminución de los rangos articulares y gran limitación para las actividades de la vida diaria. En la evaluación subjetiva obtuvimos 19 pacientes con buenos resultados, 12 regulares y 4 malos; en la evaluación objetiva obtuvimos 22 pacientes con buenos resultados, 9 regulares y 4 malos. Según los resultados obtenidos, la cortisona intraarticular parece ser un excelente tratamiento paliativo en la artropatía crónica hemofílica.Thirty four patients with chronic haemophilic arthropathy (25 grade III and 9 grade IV), having all axial deformities, muscular atrophy, and limitation of range of motion in the joint (31 knees, 2 ankles and 2 shoulders) were injected intrarticulary at 3 weeks interval with a long standing cortisone from 1 to 9 injections. Subjective and objective evaluation parameters were assessed considering as good no pain, increase range of motion and normal activity of daily life; fair with less pain, same range of motion and slight diminution of activity of daily life; and bad with persistence of pain, less range of motion and greater diminution of activity. We obtained in subjective evaluation 19 good results, 12 fair, and 4 bad; in objective evaluation we obtained 22 good results, 9 fair, and 4 bad. In conclusion, intrarticular cortisone seems to be a reliable treatment of chronic haemophilic arthropathy

Infinite index extensions of local nets and defects

Subfactor theory provides a tool to analyze and construct extensions of Quantum Field Theories, once the latter are formulated as local nets of von Neumann algebras. We generalize some of the results of [LR95] to the case of extensions with infinite Jones index. This case naturally arises in physics, the canonical examples are given by global gauge theories with respect to a compact (non-finite) group of internal symmetries. Building on the works of Izumi, Longo, Popa [ILP98] and Fidaleo, Isola [FI99], we consider generalized Q-systems (of intertwiners) for a semidiscrete inclusion of properly infinite von Neumann algebras, which generalize ordinary Q-systems introduced by Longo [Lon94] to the infinite index case. We characterize inclusions which admit generalized Q-systems of intertwiners and define a braided product among the latter, hence we construct examples of QFTs with defects (phase boundaries) of infinite index, extending the family of boundaries in the grasp of [BKLR16].Comment: 50 page

Pure red cell aplasia induced by epoetin zeta

Pure red cell aplasia (PRCA) may develop in patients with chronic kidney disease receiving erythropoiesis-stimulating agents (ESA). We report on a 72-year-old patient who developed hypo-proliferative anaemia unresponsive to ESA following the administration of epoetin zeta subcutaneously for 7 months. On the basis of severe isolated hypoplasia of the erythroid line in the bone marrow and high-titre neutralizing anti-erythropoietin antibodies (Ab), a diagnosis of Ab-mediated PRCA was made. Epoetin zeta was discontinued and the patient was given steroids. This was associated with anaemia recovery. To our knowledge this is the first PRCA case related to epoetin zeta

Surface EMG crosstalk quantified at the motor unit population level for muscles of the hand, thigh, and calf

Crosstalk is an important source of error in interpreting surface electromyography (EMG) signals. Here, we aimed at characterizing crosstalk for three groups of synergistic muscles by the identification of individual motor unit action potentials. Moreover, we explored whether spatial filtering (single and double differential) of the EMG signals influences the level of crosstalk. Three experiments were conducted. Participants (total twenty-five) performed isometric contractions at 10% of the maximal voluntary contraction (MVC) with digit muscles and knee extensors, and at 30% MVC with plantar flexors. High-density surface EMG signals were recorded and decomposed into motor unit spike trains. For each muscle, we quantified the crosstalk induced to neighboring muscles and the level of contamination by the nearby muscle activity. We also estimated the influence of crosstalk on the EMG power spectrum and intermuscular correlation. Most motor units (80%) generated significant crosstalk signals to neighboring muscle EMG in monopolar recording mode, but this proportion decreased with spatial filtering (50% and 42% for single and double differential, respectively). Crosstalk induced overestimations of intermuscular correlation and has a small effect on the EMG power spectrum, which indicates that crosstalk is not reduced with high-pass temporal filtering. Conversely, spatial filtering diminished the crosstalk magnitude and the overestimations of intermuscular correlation, confirming to be an effective and simple technique to reduce crosstalk. This paper presents a new method for the identification and quantification of crosstalk at the motor unit level and clarifies the influence of crosstalk on EMG interpretation for muscles with different anatomy

Estimation of User's Orientation via Wearable UWB

User's orientation in indoor environments is an important part of her context. Orientation can be useful to understand what the user is looking at, and thus to improve the interaction between her and the surrounding environment. In this paper, we present a method based on wearable UWB-enabled devices. The position of the devices in space is used to estimate the user's orientation. We experimentally evaluated the impact of some operational parameters, such as the distance between worn devices, or some environmental conditions, such as the position of the user in the room. Results show that the accuracy of the method suits the needs of a wide range of practical purposes

Spinal motoneurons of the human newborn are highly synchronized during leg movements

Motoneurons of neonatal rodents show synchronous activity that modulates the development of the neuromuscular system. However, the characteristics of the activity of human neonatal motoneurons are largely unknown. Using a noninvasive neural interface, we identified the discharge timings of individual spinal motoneurons in human newborns. We found highly synchronized activities of motoneurons of the tibialis anterior muscle, which were associated with fast leg movements. Although neonates' motor units exhibited discharge rates similar to those of adults, their synchronization was significantly greater than in adults. Moreover, neonatal motor units showed coherent oscillations in the delta band, which is directly translated into force generation. These results suggest that motoneuron synchronization in human neonates might be an important mechanism for controlling fast limb movements, such as those of primitive reflexes. In addition to help revealing mechanisms of development, the proposed neural interface might monitor children at risk of developing motor disorders

Should we really STOP treating patients with IgA nephropathy with steroids?

IgA nephropathy (IgAN) is the most common primary glomerulonephritis all over the world. Once considered as a benign disease, today the scientific community is aware that a significant percentage of patients eventually progress to end-stage kidney disease (ESKD). The rate of progression is often very slow. Since 1980s, several therapeutic attempts have been made with steroids. Despite different molecules, doses, and lengths of treatment, the majority of uncontrolled and controlled studies found benefits in terms of proteinuria reduction and reduction of the risk of ESKD. This was obtained with reasonable safety and tolerability, especially when steroids are given at relatively low dose and for a period not exceeding 6 months. Recently, two randomized controlled trials have questioned the efficacy and safety of steroid therapy in IgAN. However, these trials have many drawbacks that are to be considered when interpreting the findings

Professional killers: The role of extracellular vesicles in the reciprocal interactions between natural killer, CD8+ cytotoxic T-cells and tumour cells

Extracellular vesicles (EVs) mediate the cross-talk between cancer cells and the cells of the surrounding Tumour Microenvironment (TME). Professional killer cells include Natural Killer (NK) cells and CD8+ Cytotoxic T-lymphocytes (CTLs), which represent some of the most effective immune defense mechanisms against cancer cells. Recent evidence supports the role of EVs released by NK cells and CTLs in killing cancer cells, paving the road to a possible therapeutic role for such EVs. This review article provides the state-of-the-art knowledge on the role of NK- and CTL-derived EVs as anticancer agents, focusing on the different functions of different sub-types of EVs. We also reviewed the current knowledge on the effects of cancer-derived EVs on NK cells and CTLs, identifying areas for future investigation in the emerging new field of EV-mediated immunotherapy of cancer

Altered miR-193a-5p expression in children with cow's milk allergy

Cow's milk allergy (CMA) is one of the most common food allergies in children. Epigenetic mechanisms have been suggested to play a role in CMA pathogenesis. We shown that DNA methylation of Th1/Th2 cytokine genes and FoxP3 affects CMA disease course. Preliminary evidence suggest that also the miRNome could be implicated in the pathogenesis of allergy. Main study outcome was to comparatively evaluate miRNome in children with CMA and in healthy controls

A prototype of a large tunable Fabry–Pérot interferometer for solar spectroscopy

Large Fabry-Pérot Interferometers (FPIs) are used in a variety of astronomical instrumentation, including spectro-polarimeters for 4 m class solar telescopes. In this work we comprehensively characterize the cavity of a prototype 150 mm FPI, sporting a novel, fully symmetric design. Of particular interest, we define a new method to properly assess the gravity effects on the interferometer's cavity when the system is used in either the vertical or horizontal configuration, both typical of solar observations. We show that the symmetric design very effectively limits the combined effects of pre-load and gravity forces to only a few nm over a 120 mm diameter illuminated surface, with gravity contributing ~2 nm peak-to-valley (~0.3 nm rms) in either configuration. We confirm a variation of the tilt between the plates of the interferometer during the spectral scan, which can be mitigated with appropriate corrections to the spacing commands. Finally, we show that the dynamical response of the new system fully satisfies typical operational scenarios. We conclude that large, fully symmetric FPIs can be safely used within solar instrumentation in both, horizontal and vertical position, with the latter better suited to limiting the overall volume occupied by such an instrument