Porphyria cutanea tarda, dermatomyositis and non-Hodgkin lymphoma in virus C infection

Virus C infection has been associated with a broad spectrum of extrahepatic diseases such as essential mixed cryoglobulinemia, membranous glomerulonephritis, vasculitis, rheumatoid arthritis and lupus erythematosus. The etiologic role of virus C has also been observed in some neoplasms such as non-Hodgkin’s lymphoma and the monoclonal gammapathies. Many studies also support the link between this virus and porphyria cutanea tarda (PCT). Isolated cases suggest a relationship with dermatomyositis. Herein, we report the coexistence of PCT, non-Hodgkin’s lymphoma and dermatomyositis in the same patient affected with virus C infection which has never previously been described

Systemic lupus erythematosus-associated anetoderma and anti-phospholipid antibodies

Anetoderma is characterized by a loss of normal elastic tissue that presents clinically as localized areas of wrinkled or flaccid skin. We describe the case of a 30-year-old woman with systemic lupus erythematosus-associated anetoderma and positive anti-phospholipid antibodies. We discuss the possible role of these antibodies in the pathogenesis of anetoderma, and, when detected, the need to check for an associated anti-phospholipid syndrome in such patients

Speed Management in Small Cities and Towns—Guidelines for Indiana

Many small cities and towns in rural states such as Indiana are crossed by arterial highways. The local traffic on these roads, particularly vulnerable road users, face the excessive risk of injury and death. This danger is amplified with local land development, driveways, and on-street parking in town centers. This report presents an Indiana study of the speeding problem on arterial roads passing through small communities. Past research on various countermeasures suitable for the studied conditions were identified and the connection between speed reduction and safety improvements was investigated in a sample of Indiana small towns. Promising speed-reduction measures include speed feedback signs and converging chevrons with speed limit legends marked on the pavement. Point-to-point enforcement is a modern and highly effective alternative that may be applicable on highways passing small towns if the through traffic prevails with limited interruptions. This report provides a method of evaluating the benefits of speed reduction in the studied conditions where the risk of severe injury and fatality is excessive to road users while the frequency of crashes is low. The method includes the proactive estimation of the economic benefit. The results indicate that both the local and through traffic on highways passing a small town benefit considerably from speed reduction even after accounting for the loss of time. An Excel spreadsheet developed in the study facilitates the calculations

A Fuzzy k-Nearest Neighbors Classifier to Deal with Imperfect Data

© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Soft Computing. To access the final edited and published work see https://doi.org/10.1007/s00500-017-2567-xThe k-nearest neighbors method (kNN) is a nonparametric, instance-based method used for regression and classification. To classify a new instance, the kNN method computes its k nearest neighbors and generates a class value from them. Usually, this method requires that the information available in the datasets be precise and accurate, except for the existence of missing values. However, data imperfection is inevitable when dealing with real-world scenarios. In this paper, we present the kNNimp classifier, a k-nearest neighbors method to perform classification from datasets with imperfect value. The importance of each neighbor in the output decision is based on relative distance and its degree of imperfection. Furthermore, by using external parameters, the classifier enables us to define the maximum allowed imperfection, and to decide if the final output could be derived solely from the greatest weight class (the best class) or from the best class and a weighted combination of the closest classes to the best one. To test the proposed method, we performed several experiments with both synthetic and realworld datasets with imperfect data. The results, validated through statistical tests, show that the kNNimp classifier is robust when working with imperfect data and maintains a good performance when compared with other methods in the literature, applied to datasets with or without imperfection

Síndrome de Reiter exacerbado por indometacina

A 26-year-old man, with a personal history of drug abuse and positive serology for HIV, had Reiter's syndrome for six years. He experienced progressive worsening of his cutaneous lesions after initiation of indomethacin therapy. The skin lesions were almost completely resolved after the discontinuance of the drug and its reintroduction resulted in a similar deterioration. To our knowledge, indomethacin has not been reported to aggravate Reiter's syndrome. This case study documents anti-inflammatory drugs as possible causal factors for triggering Reiter's syndrome. Possible implicated mechanisms are also discussed

Differential modulation of IL-8 and TNF-α expression in human keratinocytes by buflomedil chlorhydrate and pentoxifylline

Pentoxifylline (PTX) is a methylxanthine derivative used in a wide range of dermatoses. As well as its hemorrheologic activity, PTX has anti-inflammatory properties. Buflomedil chlorhydrate (BC) is another hemorrheological drug with peripheral vasodilatory action, whose clinical uses are similar to those of PTX. Both drugs increase intracellular levels of cAMP, either secondary to phosphodiesterase inhibition (PTX) or adenyl-cyclase stimulation (BC). Long-term cultures of normal human keratinocytes were prepared in a free-serum medium, and stimulated with 1 mg/ml of phorbol 12-myristate 13-acetate (TPA) and PTX or BC (100-1000 micrograms/ml). Levels of TNF-alpha, IL-1 alpha, IL-1 beta, IL-8 and TGF-beta 1 using ELISA and Northern blot or RT-PCR techniques were measured. TPA-induced TNF-alpha and IL-8 release from keratinocytes. TPA did not induce IL-1 alpha or IL-1 beta release of keratinocytes. TPA increased RNA expression of the TNF-alpha, IL-1 alpha, IL-1 beta, IL-8 and TGF-beta 1. BC diminished TPA-induced TNF-alpha and IL-8 release from keratinocytes; in the case of IL-8 it is possible that this inhibition occur to transcriptional level. Moreover PTX was unable to inhibit TNF-alpha and IL-8 synthesis and expression. PTX and BC reduced TPA-induced IL-1 alpha and beta expression. It is possible that BC action is specifically exerted on keratinocytes, because we did not find similar results with TNF-alpha and IL-8 synthesis in mononuclear peripheral blood cells