Rituximab in the treatment of inflammatory myopathies: a review

Several uncontrolled studies have encouraged the use of rituximab (RTX) in patients with myositis. Unfortunately, the first placebo-phase trial to assess the efficacy of RTX in refractory myositis did not show a significant difference between the two treatment groups, and doubts have been expressed about its study design. In this review we present an up-to-date overview of the reported experiences of RTX therapy in myositis. A PubMed search was performed to find all the available cases of refractory myositis patients treated with RTX up to July 2015. The following terms were assessed: inflammatory myopathies OR anti-synthetase syndrome OR polymyositis OR dermatomyositis AND RTX. A total of 48 studies were included. We identified 458 patients with myositis treated with RTX. We found a rate of response to RTX of 78.3%. RTX can play a role in the management of patients with myositis, at least in those with positive myositis-specific autoantibodies

Suicide attempts in mexican teenagers: a cultural consensus theory perspective

El suicidio es un problema de salud pública mundial y los adolescentes son los que presentan con mayor frecuencia esta problemática. El estudio realizado identifica la estructura semántica del dominio cultural, el promedio de conocimiento y el grado de consenso cultural que sobre el suicidio tienen adolescentes con tentativa suicida. El trabajo es un estudio cualitativo mediante la técnica de listas libres. Participaron 29 adolescentes (13 a 18 años). Las listas libres fueron sobre: las causas; los signos y los síntomas; lo que siente, piensa y hace un adolescente antes de cometer suicidio y las estrategias de prevención de éste. Los resultados muestran para cada pregunta un único modelo semántico en el dominio cultural. En lo estructural se identifican los problemas familiares como la causa del intento suicida; la depresión y la tristeza son síntomas previos al intento suicida. La tristeza y la soledad, salir del problema y suicidarse es lo que considera que siente, piensa y hace un adolescente previo al intento de suicidio. Como estrategias de prevención, se identifican le ponga más atención y hablar con él. Los resultados ponderan la importancia de la familia para los programas de prevención de las conductas suicidas en adolescentes. The suicide is a problem of public world health and the adolescents are those who present with more frequency this problem. Nevertheless, the studies of the suicide phenomenon from a cultural perspective are limited. Cultural research in suicidology is important to develop the understanding of the meanings of suicidal behavior in different contexts. The cultural consensus theory would contribute to the cultural perspective of the knowledge of suicidal behaviors in terms of its internal elements and their functioning (emic) and this theory allows knowing if there exists a knowledge shared by a social group regarding an issue and allows to recognize its organization. The aim of this study was to identify the semantic structure of the cultural domain, as well as the average of knowledge and the degree of cultural consensus regarding suicide among adolescent suicide attempters. It was a qualitative study, using the free-listing technique, with a non-random sample made up of 29 adolescents between the ages of 13 and 18 years. The free lists were on: the causes; the signs and the symptoms; what he/she feels, thinks and does before attempting suicide and the strategies of suicide prevention at adolescence. The results showed for every question a single semantic model in the cultural domain suicide attempt. In such structure, the family problems were identified as the cause of suicidal attempt; the depression and the sadness were symptoms before suicidal attempt. The sadness, the loneliness and the anger were what an adolescent feels before the suicide attempt. Furthermore, to get out of the problem and to end his/her life were what an adolescent thinks before attempting suicide and to commit suicide was what an adolescent does before to suicide attempt. To pay more attention, to talk with the adolescent, to improve the communication with the parents and to attend a psychotherapy were identified as strategies for suicide prevention. The results highlight the importance of the family of suicide prevention programs for adolescents based on cultural knowledge.ITESO, A.C.Universidad de GuadalajaraInstituto Mexicano del Seguro SocialPsicólogos Especializados Jalisc

Del contexto cultural al funcionamiento familiar. Conocimientos compartidos y relaciones familiares en adolescentes con intento de suicidio

El objetivo de este texto es identificar y comparar la estructura semántica del dominio cultural, el conocimiento promedio y el grado de consenso cultural sobre las causas del intento de suicidio, los síntomas previos y las estrategias de prevención del intento de suicidio, además evaluar el funcionamiento familiar entre adolescentes mexicanos con y sin intento de suicidio. Se presenta un estudio mixto metodológicamente que usa la técnica de listas libres y el inventario de recursos familiares en una muestra propositiva de 65 adolescentes (13 a 18 años) divididos en dos grupos: el grupo de adolescentes con tentativa suicida y un grupo control con adolescentes estudiantes sin antecedentes de conductas suicidas. Los problemas familiares fueron la principal causa del intento suicida, mientras que la depresión y la tristeza fueron síntomas previos a una tentativa suicida en ambos grupos. La ayuda psicológica y el desarrollo de habilidades de escucha en los padres fueron señaladas como las estrategias para la prevención del suicidio. Respecto del funcionamiento familiar, los adolescentes con tentativa suicida percibieron más conflictos familiares y menor comunicación y apoyo en sus familias en comparación con el grupo control. Los resultados sugieren un conocimiento compartido culturalmente sobre las causas, los síntomas y las estrategias de prevención del intento de suicidio en los adolescentes, el cual se confirma en la percepción del funcionamiento familiar. La familia, elemento central en la cultura mexicana, debe ser considerada en las estrategias de prevención del intento de suicidio en los adolescentes en México. AIM: The aim of the study was to identify and to compare the semantic structure of the cultural domain, the average knowledge and the degree of cultural consensus regarding knowledge of suicide attempts cause, symptoms and prevention strategies to suicide attempt and the family functioning among Mexican adolescents with and without previous suicide attempt. Method: It was a mixed study, using the free-listing technique and an inventory of family resources, with a non-random sample of 65 adolescents (13-18 years) divided in two groups. The suicide attempters group and the control group were high school students, without a history of suicide behaviors. Results: Family problems were identified as the most important cause of suicide attempts in both groups, while depression and sadness were identified as symptoms prior to the suicide attempt in both groups. Psychological aid and development of listening skills in the parents were the most frequent responses regarding prevention strategies to suicide attempt. Regarding family functioning teenage suicide attempters showed more family conflict, less family communication and support than teenage non suicide attempters. Conclusions: The results suggest a same cultural knowledge background regarding causes, symptoms prior and prevention strategies to suicide attempt in Mexican adolescents. Mexican culture centered in family relationships is important to be considered in design of prevention strategies to suicide attempt in adolescence in Mexico.ITESO, A.C

Evaluation of an automated safety surveillance system using risk adjusted sequential probability ratio testing

<p>Abstract</p> <p>Background</p> <p>Automated adverse outcome surveillance tools and methods have potential utility in quality improvement and medical product surveillance activities. Their use for assessing hospital performance on the basis of patient outcomes has received little attention. We compared risk-adjusted sequential probability ratio testing (RA-SPRT) implemented in an automated tool to Massachusetts public reports of 30-day mortality after isolated coronary artery bypass graft surgery.</p> <p>Methods</p> <p>A total of 23,020 isolated adult coronary artery bypass surgery admissions performed in Massachusetts hospitals between January 1, 2002 and September 30, 2007 were retrospectively re-evaluated. The RA-SPRT method was implemented within an automated surveillance tool to identify hospital outliers in yearly increments. We used an overall type I error rate of 0.05, an overall type II error rate of 0.10, and a threshold that signaled if the odds of dying 30-days after surgery was at least twice than expected. Annual hospital outlier status, based on the state-reported classification, was considered the gold standard. An event was defined as at least one occurrence of a higher-than-expected hospital mortality rate during a given year.</p> <p>Results</p> <p>We examined a total of 83 hospital-year observations. The RA-SPRT method alerted 6 events among three hospitals for 30-day mortality compared with 5 events among two hospitals using the state public reports, yielding a sensitivity of 100% (5/5) and specificity of 98.8% (79/80).</p> <p>Conclusions</p> <p>The automated RA-SPRT method performed well, detecting all of the true institutional outliers with a small false positive alerting rate. Such a system could provide confidential automated notification to local institutions in advance of public reporting providing opportunities for earlier quality improvement interventions.</p

Circumsolar energetic particle distribution on 2011 November 3

Late on 2011 November 3, STEREO-A, STEREO-B, MESSENGER, and near-Earth spacecraft observed an energetic particle flux enhancement. Based on the analysis of in situ plasma and particle observations, their correlation with remote sensing observations, and an interplanetary transport model, we conclude that the particle increases observed at multiple locations had a common single source active region and the energetic particles filled a very broad region around the Sun. The active region was located at the solar backside (as seen from Earth) and was the source of a large flare, a fast and wide coronal mass ejection, and an EIT wave, accompanied by type II and type III radio-emission. In contrast to previous solar energetic particle events showing broad longitudinal spread, this event showed clear particle anisotropies at three widely separated observation points at 1AU, suggesting direct particle injection close to the magnetic footpoint of each spacecraft, lasting for several hours.We discuss these observations and the possible scenarios explaining the extremely broad particle spread for this event

Mechanical and antimicrobial properties of low-density-polyethylene/MgO nanocomposites

Low-density polyethylene (LDPE) nanocomposites containing magnesium oxide (MgO) nanoparticles are obtained by melt mixing. MgO nanoparticles ca. 29 ± 2 nm are synthesized by sol–gel and organically modified on the surface with oleic acid (Mod-MgO), whose final concentration in the polymers is 3, 5, and 10 wt%. The presence of these nanoparticles did not affect the crystallization process of LDPE. However, Young's modulus increases with 10 wt% of Mod-MgO nanoparticles, rendering higher reinforcement effects with an increase as high as 48%. This affects the elongation at break, which decreases ca. 57% compared to neat LDPE. The storage and loss modulus of the LDPE/MgO and LDPE/Mod-MgO nanocomposites increases at room temperature and low temperatures (−150 to −50°C) compared to neat LDPE. SEM analysis showed that the organic modification of MgO nanoparticles improved their dispersion within the polymer matrix. Nanocomposites present antimicrobial properties against Escherichia coli, reaching an efficiency ca. 53%.Paula A. Zapata thanks the financial support under FONDECYT Regular Project 1220093. Viviana Moreno-Serna thanks the ANID FON-DECYT Postdoctorado 3210077. Carlos Loyo and Raúl Vallejos thank Proyecto de Dirección de Investigación Científica y tecnológica (DICYT), 022141ZR_POSTDOC, USA2055, Universidad de Santiago de Chile

Direct Polyphenol Attachment on the Surfaces of Magnetite Nanoparticles, Using Vitis vinifera, Vaccinium corymbosum, or Punica granatum

This study presents an alternative approach to directly synthesizing magnetite nanoparticles (MNPs) in the presence of Vitis vinifera, Vaccinium corymbosum, and Punica granatum derived from natural sources (grapes, blueberries, and pomegranates, respectively). A modified co-precipitation method that combines phytochemical techniques was developed to produce semispherical MNPs that range in size from 7.7 to 8.8 nm and are coated with a ~1.5 nm thick layer of polyphenols. The observed structure, composition, and surface properties of the MNPs@polyphenols demonstrated the dual functionality of the phenolic groups as both reducing agents and capping molecules that are bonding with Fe ions on the surfaces of the MNPs via –OH groups. Magnetic force microscopy images revealed the uniaxial orientation of single magnetic domains (SMDs) associated with the inverse spinel structure of the magnetite (Fe3O4). The samples’ inductive heating (H0 = 28.9 kA/m, f = 764 kHz), measured via the specific loss power (SLP) of the samples, yielded values of up to 187.2 W/g and showed the influence of the average particle size. A cell viability assessment was conducted via the MTT and NRu tests to estimate the metabolic and lysosomal activities of the MNPs@polyphenols in K562 (chronic myelogenous leukemia, ATCC) cells