Statins and Mortality in Connective Tissue Diseases: Should We Resume the Cardio-rheumatology Spirit in Our Clinics?

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Silent acro-osteolysis in a patient with psoriatic disease and recurrent micro-trauma

A 42-year-old woman with a 15-year history of psoriatic disease with skin, nail and joint involvement presented for routine follow-up visit. The patient did not complain of relevant articular symptoms, physical examination was unremarkable excepted for feet nail onychodystrophy and routine laboratory tests were unaltered

Rituximab retention rate in systemic sclerosis: a long term real-life multicenter study

eywords: B-cells; real-life data; retention rate; rituximab; systemic sclerosis

Management of systemic sclerosis: British Society for Rheumatology guideline scope

This guideline will provide a practical roadmap for management of SSc that builds upon the previous treatment guideline to incorporate advances in evidence-based treatment and increased knowledge about assessment, classification and management. General approaches to management as well as treatment of specific complications will be covered, including lung, cardiac, renal and gastrointestinal tract disease, as well as RP, digital vasculopathy, skin manifestations, calcinosis and impact on quality of life. It will include guidance related to emerging approved therapies for interstitial lung disease and account for National Health Service England prescribing policies and national guidance relevant to SSc. The guideline will be developed using the methods and processes outlined in Creating Clinical Guidelines: Our Protocol. This development process to produce guidance, advice and recommendations for practice has National Institute for Health and Care Excellence accreditation

An unusual lung involvement in scleroderma: lipoid pneumonia

No abstract availabl

Management of systemic sclerosis: British Society for Rheumatology guideline scope

This guideline will provide a practical roadmap for management of SSc that builds upon the previous treatment guideline to incorporate advances in evidence-based treatment and increased knowledge about assessment, classification and management. General approaches to management as well as treatment of specific complications will be covered, including lung, cardiac, renal and gastrointestinal tract disease, as well as RP, digital vasculopathy, skin manifestations, calcinosis and impact on quality of life. It will include guidance related to emerging approved therapies for interstitial lung disease and account for National Health Service England prescribing policies and national guidance relevant to SSc. The guideline will be developed using the methods and processes outlined in Creating Clinical Guidelines: Our Protocol. This development process to produce guidance, advice and recommendations for practice has National Institute for Health and Care Excellence accreditation

Proteomic and functional characterization of serum extracellular vesicles In progressive scleroderma interstitial lung disease

Background Systemic sclerosis (SSc) is the disease associated with the highest mortality among rheumatic conditions, mainly as a direct or indirect consequence of interstitial lung disease (ILD). Reliable biomarkers to timely predict the progression of lung fibrosis and guide the treatment are lacking. Extracellular vesicles (EVs) are newly discovered mediators of intercellular communication providinga cell-specific exchange of functionally active molecules. Aim of the study The main objective of the study was to compare circulating EV proteome profiles of SSc patients with progressive ILD, non-progressive ILD, and without ILD. The exploratory objective was to assess the capacity of SSc serum EV lysates to induce epithelial-to-mesenchymal transition (EMT) of alveolar epithelial cells (AECs) or activation of lung fibroblasts (HLFs) in vitro. Methods Serum EVs were enriched from selected SSc patients classified into three clinical groups according to ILD status and 24-month follow-up (patients with progressive ILD, non-progressive ILD, and without ILD). The EV enrichment process result was evaluated by Western blot (WB) characterization of EV markers and transmission electronic microscopy (TEM). The proteomic profile was assessed though proximity extension assay (PEA) on EVs lysate, combined with new generation sequencing (NGS) of about 3000 proteins. A Gene Set Enrichment Analysis (GSEA) was performed to determine whether a priori-defined sets of functionally related proteins were differentially represented between the clinical groups. The biological activity of EV lysates was explored though exposure of human A549 AEC and HLF cell cultures for 48 hours in standard conditions. EMT and HLF activity marker expression was assessed by real-time polymerase chain reaction (RT-PCR) and WB of the cell culture extracted samples. Results Of the 52 patients included in the final analysis (age of 57.0 ± 12.5 years, males 21.2%), 53.8% presented the diffuse cutaneous variant (dcSSc) with a median disease duration of 6.0 years; 80.8% and 65.4% of the patients were respectively exposed to vasoactive and immunosuppressive treatments during the observation period. Of 38 (73.1%) patients presenting ILD, 13 were progressors and 25 non-progressors, while the remaining 14 did not present ILD. A total of 1161 proteins were detected in all the EV-lysate samples and 1456 in at least one sample. Among the cell-specific EV-related markers evaluated on PEA, the most abundant suggested a prevalent platelet, endothelial, or immune-cell origin for circulating EVs. Two-hundred-twenty-one single proteins differed between SSc patients with and without ILD, and 189 between progressive and non-progressive SSc-ILD patients. The GSEA revealed for both comparisons some differences in the abundance of proteins involved in EMT-related processes (such as epithelial carcinogenesis, organogenesis, and expression of surface cellular markers), extracellular matrix (ECM) metabolism, angiogenesis, and vesicle trafficking. Differences in adaptive immune response-related proteins were specifically reported in the comparison between SSc patients with and without ILD, while EV lysates from progressive and non-progressive SSc-ILD patients differed in the abundance of proteins involved in the metabolism of reactive oxygen species and xenobiotics. The exploratory functional assessment finally revealed an EMT induction after the exposure of A549 AEC cell cultures with EV-lysate from SSc-ILD patients but not from SSc patients without ILD. Significant reactions were not reported after exposure of HLFs to EV-lysates. Conclusions Serum EV-lysates derived from SSc patients differ in proteomic profiles according to the presence of ILD and the occurrence of ILD progression over time. The differently abundant proteins are related to key pathways involved in SSc pathogenesis, such as EMT, ECM deposition and remodelling, angiogenesis, immune response, and the reaction to oxidative stress and xenobiotics. The observation of AEC EMT after EV lysate exposure supports the hypothesis of a direct pathogenetic role for circulating EVs in SSc-related lung fibrosis

Protein Chips for Detection of Salmonella spp. from Enrichment Culture

Food pathogens are the cause of foodborne epidemics, therefore there is a need to detect the pathogens in food productions rapidly. A pre-enrichment culture followed by selective agar plating are standard detection methods. Molecular methods such as qPCR have provided a first rapid protocol for detection of pathogens within 24 h of enrichment culture. Biosensors also may provide a rapid tool to individuate a source of Salmonella contamination at early times of pre-enrichment culture. Forty mL of Salmonella spp. enrichment culture were processed by immunoseparation using the Pathatrix, as in AFNOR validated qPCR protocols. The Salmonella biosensor combined with immunoseparation showed a limit of detection of 100 bacteria/40 mL, with a 400 fold increase to previous results. qPCR analysis requires processing of bead-bound bacteria with lysis buffer and DNA clean up, with a limit of detection of 2 cfu/50 μL. Finally, a protein chip was developed and tested in screening and identification of 5 common pathogen species, Salmonella spp., E. coli, S. aureus, Campylobacter spp. and Listeria spp. The protein chip, with high specificity in species identification, is proposed to be integrated into a Lab-on-Chip system, for rapid and reproducible screening of Salmonella spp. and other pathogen species contaminating food productions

Immersive virtual reality for procedural training: comparing traditional and learning by teaching approaches

Virtual Reality (VR) has been widely adopted for the creation of training experiences, since it appears to allow overcoming, especially for practical training, some of the limitations of real exercises. Many previous works focused on investigating the effectiveness of VR Training Systems (VRTS) in a variety of fields, but the efficacy of these systems is very task-dependent, and the best way to integrate them into existing learning paths has yet to be thoroughly investigated. The goal of the present paper is to explore the latter aspects considering a case study in the context of energy management in industry, and focusing on a measuring procedure that is part, e.g., of energy audit inspections. To this aim, a VRTS was developed and used to conduct two user studies: a first study designed to investigate the effectiveness of the devised system when used as an alternative or in combination with lecture and laboratory-based teaching experiences, and a second study aimed to compare two different approaches (traditional learning, TL, and learning by teaching, LBT) for exploiting the provided VR-based functionalities in a learning path. Experimental results showed that the use of the VRTS alone improved the participants’ performance compared to traditional experiences, and that LBT proved to be more effective that TL for practical learning purposes